The Diagnostic Significance of 67 Gallium Lung Scan and High Resolution Computed Tomography in Patients with Pulmonary Tuberculosis

Kim, Jin Gon; Kim, Jin Wook; Kim, Hong Nam; Choi, Byeong Jin; Ryou, Kwang Hyun; Kim, So Yon; Park, Byong Yik; Lee, Gwon Jun

Abstract

OBJECTIVE
The activity of pulmonary tuberculosis has been usually detarmined by smear and culture of AFB in sputum and serial chest X ray. However it is sorntimes difficult to determine the activity of pulmonary tuberculosis by either. We have studied Gallium lung scan 4 HRCT in the patients with pulmonary tuberculosis to determine its activity and compared their diagnostic significance.
METHODS
67Gallium lung scan and HRCT were examined in 63 patients with pulmonary tuberculosis suspected by chest X ray and were compared each other with their possible diagnostic significance in determination of activity. The active pulmonary tuberculosis was defined by positive AFB smear and/ or culture in sputum and changes of findings in serial chest X ray.
RESULTS
1) Of 63 patients with pulmonary tuberculosis, 37 patients has been diagnosed active 9 patients were diagnosed by positive AFB smear in sputum, 20 patients by positive AFB culture in sputum and 8 patients by changes of findings in serial chest X ray. 2) In the 37 patients with active pulmonary tuberculosis, chest X ray revealed active pulmonary tuberculosis findings in 28 patients, inactive in 4 patients and undetermined in 5 patients. On the contrary, In the 26 patients with inactive pulmonary tuberculosis, the chest X ray revealed active pulmonary tuberculosis findings in 6 patients, inactive in 16 patients and undetermined in 4 patients. 3) 67Gallium lung scan showed positive uptake in 34 patients of the 37 patients with active pulmonary tuberculosis, but did not show any uptake at all in 26 patients with inactive pulmonary tuberculosis. 4) HRCT showed active findings in 36 patients of the 37 patients with pulmonary tuberculosis. And it showed active findings in 4 patients of the 26 patients with inactive pulmonary tuberculosis.
CONCLUSION
The Gallium lung scan showed 82% of sensitivity and 8% of false negativity. And HRCT showed 97% of sensitivity and 15% of false positivity. In the aspect of laboratory examinations for the determination of activity in pulmonary tuberculosis the 67Gallium lung scan and the HRCT appeared useful.