Radiographic Evaluation of Tuberculosis: a retrospective study among patients in Al- Mouwasat hospital in Damascus

Abstract Background Tuberculosis (TB) presents a significant global health challenge, affecting both pulmonary and extrapulmonary sites and yielding diverse radiological manifestations. These manifestations, ranging from subtle parenchymal changes to overt abnormalities, include features such as infiltrates, nodules, cavitations, and pleural effusion, often reflecting disease stage, immune status, and anatomical site involvement. Understanding these manifestations is crucial for accurate diagnosis and timely intervention, with radiographic imaging techniques such as chest X-rays and CT scans playing pivotal roles in evaluating TB, alongside advancements in technology enhancing detection and characterization of TB-related abnormalities. Methods A retrospective cross-sectional study was conducted utilizing patient records and imaging data collected from 2020 to 2023. Inclusion criteria comprised patients diagnosed with tuberculosis (TB) during this period. Ethical approval was obtained from the institutional review board or ethics committee, ensuring patient confidentiality and data anonymization. Informed consent was not required due to the retrospective nature of the study. Statistical analysis was performed using SPSS version 26.0, computing descriptive statistics including frequencies, percentages, means, and standard deviations. Results Our study found a 46–54% male-to-female ratio. Tuberculin skin test positivity was 90%, with 85% showing fever elevation. Upper lobe involvement was seen in 75% of cases, with cavitations present in 3% (chest radiograph) and 22% (CT scan). Pleural effusion occurred in 30% (chest radiograph) and 76% (CT scan), with a density exceeding 20 Hounsfield units in 72%. Bronchial wall thickening was noted in 42% (chest radiograph) and 85% (CT scan). Tree-in-bud appearance was observed in 68% (chest radiograph) and 82% (CT scan). Initial upper lobe involvement with tuberculosis was found in 92% of cases. Hilar lymphadenopathy was present in 69% (chest radiograph) and 88% (CT scan), with lymph nodes measuring 15–20 mm most common at 63%. High-density nodes were seen in 81% and peripheral enhancement in 82% of cases. Lymph nodes in the right hilum were most prevalent at 90%. Segmental consolidation was highest at 85%, with heterogeneous density on CT scan observed in 63% of cases. Thick-walled cavities were seen in 69%, and centrilobular nodules (1–3 mm diameter) were observed in 92%. High-resolution CT scan demonstrated 90% accuracy in diagnosing tuberculosis. Conclusions Early diagnosis of tuberculosis (TB) is crucial to prevent adverse outcomes. Radiological diagnostic methods play a vital role in identifying TB and its manifestations. This study explores key radiographic signs of primary and post-primary TB, along with their complications. Additionally, it evaluates the accuracy of radiographic imaging in TB diagnosis.