title: Correlation of chest computed tomography findings with dyspnea and lung functions in post-tubercular sequelae.
abstract: OBJECTIVE
  To study the correlation between dyspnea, radiological findings, and pulmonary function tests (PFTs) in patients with sequelae of pulmonary tuberculosis (TB).
  
  
  METHODS
  Clinical history, chest computed tomography (CT), and PFT of patients with post-TB sequelae were recorded. Dyspnea was graded according to the Modified Medical Research Council (mMRC) scale. CT scans were analyzed for fibrosis, cavitation, bronchiectasis, consolidation, nodules, and aspergilloma. Semi-quantitative analysis was done for these abnormalities. Scores were added to obtain a total morphological score (TMS). The lungs were also divided into three zones and scores added to obtain the total lung score (TLS). Spirometry was done for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC.
  
  
  RESULTS
  Dyspnea was present in 58/101 patients. A total of 22/58 patients had mMRC Grade 1, and 17/58 patients had Grades 2 and 3 dyspnea each. There was a significant difference in median fibrosis, bronchiectasis, nodules (P< 0.01) scores, TMS, and TLS (P< 0.0001) between dyspnea and nondyspnea groups. Significant correlations were obtained between grades of dyspnea and fibrosis (r= 0.34,P= 0.006), bronchiectasis (r= 0.35,P= 0.004), nodule (r= 0.24,P= 0.016) scores, TMS (r= 0.398,P= 0.000), and TLS (r= 0.35,P= 0.0003). PFTs were impaired in 78/101 (77.2%) patients. Restrictive defect was most common in 39.6% followed by mixed in 34.7%. There was a negative but statistically insignificant trend between PFT and fibrosis, bronchiectasis, nodule scores, TMS, and TLS. However, there were significant differences in median fibrosis, cavitation, and bronchiectasis scores in patients with normal, mild to moderate, and severe respiratory defects. No difference was seen in TMS and TLS according to the severity of the respiratory defect.
  
  
  CONCLUSIONS
  Both fibrosis and bronchiectasis correlated with dyspnea and with PFT. However, this correlation was not linear. The overall extent of radiological abnormalities correlated only with dyspnea but not with PFT.
authors.affiliation: Department of Radiodiagnosis, All Institute of Medical Sciences, New Delhi, India.
authors.forename: Ananya
authors.initials: A
authors.lastname: Panda
authors.affiliation: Department of Radiodiagnosis, All Institute of Medical Sciences, New Delhi, India.
authors.forename: Ashu Seith
authors.initials: AS
authors.lastname: Bhalla
authors.affiliation: Department of Radiodiagnosis, All Institute of Medical Sciences, New Delhi, India.
authors.forename: Raju
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Department of Pulmonary Medicine, All Institute of Medical Sciences, New Delhi, India.
authors.forename: Anant
authors.initials: A
authors.lastname: Mohan
authors.affiliation: Department of Biostatistics, All Institute of Medical Sciences, New Delhi, India.
authors.forename: Vishnu
authors.initials: V
authors.lastname: Sreenivas
authors.affiliation: Department of Pulmonary Medicine, All Institute of Medical Sciences, New Delhi, India.
authors.forename: Umasankar
authors.initials: U
authors.lastname: Kalaimannan
authors.affiliation: Department of Biostatistics, All Institute of Medical Sciences, New Delhi, India.
authors.forename: Ashish Dutt
authors.initials: AD
authors.lastname: Upadhyay
keywords: Computed tomography; dyspnea; posttubercular sequelae; pulmonary function test; pulmonary tuberculosis; radiological-functional correlation