Evaluating the prognosis of pulmonary tuberculosis with a 320-detector row dual-input computed tomography perfusion

Background: It is hard to evaluate the prognosis of chemotherapy for pulmonary tuberculosis (TB) lesions. The 320-detector row dual-input CT perfusion technique can provide a new way to predict the effect of treatment by analyzing the changes of perfusion parameters pre- and post-chemotherapy. Methods: Thirty patients with TB were divided into 2 groups: the remission group (20 cases) and the non-remission group (10 cases). All patients underwent dual-input CT perfusion scan twice at before (1 week) and after (2 weeks) chemotherapy. Then, the perfusion data, including pulmonary flow, bronchial flow, were acquired. Results: No significant lesion size changes were observed post-chemotherapy. Pretreatment pulmonary flow (57.8 ± 11.42 vs 29.44 ± 11.19 mL min⁻ 1 ·(100 mL)⁻ 1 , P < .001) and bronchial flow (BF) (31.46 ± 5.18 vs 14.06 ± 4.09 mL min⁻ 1 ·(100 mL)⁻ 1 , P < .001) in the remission group were significantly higher than those in the non-remission group. Posttreatment, the remission group showed reduced perfusion, while the non-remission group had a significant BF increase (14.06 ± 4.09 to 36.68 ± 4.41 mL min⁻ 1 ·(100 mL)⁻ 1 ). However, there was no significant difference in pulmonary flow between the remission group and the non-remission group. Conclusion: The findings showed that the patients with high pulmonary blood flow of tuberculosis are relatively sensitive to chemotherapy and have a good prognosis. Changes in perfusion values after the treatment of pulmonary tuberculosis are related to recent therapeutic efficacy; an increase in BF values suggests the progression of the tuberculosis lesions and a poorer prognosis. And the CT perfusion can be applied to the effect of the TB therapy.