Title:Analysis of the Imaging Features and Prognosis of Pulmonary Tuberculosis
Complicated with Pulmonary Embolism
Volume: 20
Author(s): Yi-Wen Zhang*, Dan Wu, Zhen-Zhen Zhu, Jin-Chun Ou, Zhuo-Chao Kong, Wen-Fang Zhu, Qing-Ming Shi and Min Wang
Affiliation:
- Department of Respiratory Medicine, Anhui Medical University Clinical College of Chest & Anhui Chest Hospital, Hefei 230022, People’s Republic
of China
Keywords:
Pulmonary embolism, Pulmonary tuberculosis, Imaging, Poor prognosis, Ipsilateral lung, Proto-B-type.
Abstract:
Objective:
This study aimed to explore the imaging characteristics of patients with pulmonary tuberculosis complicated with pulmonary embolism and
analyze the prognosis of the condition, thereby reducing the mortality and misdiagnosis rate of complications in this type of pulmonary
tuberculosis.
Methods:
In this retrospective study, a total of 70 patients diagnosed with pulmonary embolism by computed tomography pulmonary angiography (CTPA)
from January 2016 to May 2021 in Anhui Chest Hospital were included. Among them, 35 patients with pulmonary embolism combined with
pulmonary tuberculosis were set as the study group, and the other 35 patients with pulmonary embolism only were set as the control group. The
imaging findings of chest CT examination, the incidence of pulmonary hypertension, the level of N-terminal proto-B-type brain natriuretic peptide
(NT-proBNP), and the prognosis of patients were compared between the two groups. The incidence of deep venous embolism was evaluated by
ultrasonography of the lower extremity.
Results:
In the study group, the median age of patients was 71 years, and the ratio of males to females was 2.5 to 1. In the control group, the median age
was 66 years old, and the male-to-female ratio was 2.2 to 1. There were 16 cases (16/35, 45.71%) in the study group and 10 cases (10/35, 28.57%)
in the control group with an increased level of NT-proBNP. Pulmonary hypertension occurred in 10 patients (10/35, 28.57%) in the study group
and 7 patients (7/35, 20.00%) in the control group. Patients who lost follow-up included 5 in the study group (5/35, 14.29%) and 3 in the control
group (3/35, 8.57%). There were 17 cases (17/35, 48.57%) in the study group and 3 cases (3/35, 8.57%) in the control group with pulmonary artery
widening, and the difference was significant (P < 0.001). There were 13 deaths in the study group (13/35, 37.14%) and 1 death in the control group
(1/35, 2.86%), and the difference was significant (P <0.001).
Conclusion:
Special signs of pulmonary artery widening, pulmonary hypertension of varying degrees, and increased levels of NT-proBNP of varying degrees
can be found in patients with pulmonary tuberculosis complicated with pulmonary embolism, and the three signs are positively correlated. The
mortality of patients with pulmonary tuberculosis complicated with pulmonary embolism is significantly higher than that of patients with
pulmonary embolism alone. Pulmonary tuberculosis and pulmonary embolism both occur in the ipsilateral lung, causing clinical symptoms to
cover each other, thereby making diagnosis difficult.
