title: Can pleural adenosine deaminase (ADA) levels in pleural tuberculosis predict the presence of pulmonary tuberculosis? A CT analysis.
abstract: OBJECTIVE
  To assess the relationship between imaging features of pulmonary tuberculosis at computed tomography (CT) and adenosine deaminase (ADA) values via pleural fluid analysis in patients with pleural tuberculosis.
  
  
  METHODS
  This retrospective study enrolled 60 patients who underwent fluid analysis for ADA and chest CT and were diagnosed with tuberculosis by culture or polymerase chain reaction of pleural fluid and sputum. The presence of centrilobular nodules, consolidation, cavitation, and mediastinal lymphadenopathy at CT were evaluated. The relationship between ADA values and the pattern of pulmonary involvement of tuberculosis was analysed.
  
  
  RESULTS
  Pulmonary involvement was seen in 42 of the 60 patients. A centrilobular nodular pattern was seen in 37 and consolidation in 22. In 17 patients, both findings were identified. A centrilobular nodular pattern was more common than consolidation or cavitary lesions. When ADA values were high, pulmonary involvement was more frequent (p=0.002). Comparing low and high ADA groups using an obtained cut-off value of 80 IU/l, the high group had more frequent pulmonary involvement (p<0.001).
  
  
  CONCLUSIONS
  Patients with tuberculous pleurisy who had high ADA values had a higher probability of manifesting pulmonary tuberculosis. High ADA values may help predict contagious pleuroparenchymal tuberculosis. The most common pulmonary involvement of tuberculous pleurisy showed a centrilobular nodular pattern.
authors.affiliation: Department of Radiology, Hallym University College of Medicine, Anyang-city, Kyungki-do, Republic of Korea.
authors.forename: Myung Je
authors.initials: MJ
authors.lastname: Koh
authors.affiliation: Department of Radiology, Hallym University College of Medicine, Anyang-city, Kyungki-do, Republic of Korea. Electronic address: ijlee2003@medimail.co.kr.
authors.forename: In Jae
authors.initials: IJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Anyang-city, Kyungki-do, Republic of Korea.
authors.forename: Joo-Hee
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000243:Adenosine Deaminase / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000201:enzymology*; D013902:Radiography, Thoracic / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D014396:Tuberculosis, Pleural / Q000000981:diagnostic imaging* / Q000201:enzymology*; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000201:enzymology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D000243:Adenosine Deaminase