Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea.
Division of Pulmonology, Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea.
PLoS One. 2020 Oct 5;15(10):e0239431. doi: 10.1371/journal.pone.0239431. eCollection 2020.
The loss of muscle mass in primary multidrug-resistant tuberculosis (MDR-TB) has not been examined in previous studies. This study aimed to investigate that low pectoralis muscle index and characteristic CT features can help differentiate patients with primary MDR-TB from those with drug-sensitive tuberculosis (DS-TB).
From 2010 to 2016, we retrospectively enrolled 90 patients with primary MDR-TB and 90 age- and sex-matched patients with primary DS-TB. The pectoralis muscle mass was quantitatively measured on axial CT images using density histogram analysis. The pectoralis muscle index (PMI) was defined as the pectoralis muscle mass divided by body mass index. We compared the PMI and characteristic CT features of pulmonary tuberculosis between the two groups.
Low PMI, segmental to lobar consolidation, cavity in consolidation, cavitary nodule or mass, and bilateral involvement were more frequently observed in patients with MDR-TB than in those with DS-TB. In stepwise multivariate logistic regression analysis, low PMI (odds ratio, 2.776; 95% confidence interval, 1.450-5.314; p = 0.002), segmental or lobar consolidation (odds ratio, 3.123; 95% confidence interval, 1.629-5.987; p = 0.001), and cavitary nodule or mass (odds ratio, 2.790; 95% confidence interval, 1.348-5.176; p = 0.002) were significant factors for MDR-TB.
Low pectoralis muscle index, segmental to lobar consolidation and cavitary nodule or mass can help differentiate primary MDR-TB from DS-TB.
原发性耐多药结核病（MDR-TB）患者的肌肉质量损失在以前的研究中尚未得到检查。本研究旨在探讨低胸肌指数和特征性 CT 特征可帮助区分原发性 MDR-TB 与药敏性肺结核（DS-TB）患者。
我们回顾性纳入了 2010 年至 2016 年期间的 90 例原发性 MDR-TB 患者和 90 例年龄和性别匹配的原发性 DS-TB 患者。使用密度直方图分析对轴向 CT 图像进行定量测量胸肌质量。胸肌指数（PMI）定义为胸肌质量除以体重指数。我们比较了两组患者的 PMI 和肺结核的特征性 CT 特征。
与 DS-TB 患者相比，MDR-TB 患者中低 PMI、节段至肺叶实变、实变中的空洞、空洞结节或肿块和双侧受累更为常见。在逐步多元逻辑回归分析中，低 PMI（优势比，2.776；95％置信区间，1.450-5.314；p = 0.002）、节段或肺叶实变（优势比，3.123；95％置信区间，1.629-5.987；p = 0.001）和空洞结节或肿块（优势比，2.790；95％置信区间，1.348-5.176；p = 0.002）是 MDR-TB 的重要因素。
低胸肌指数、节段至肺叶实变和空洞结节或肿块有助于区分原发性 MDR-TB 与 DS-TB。
