Quantitative evaluation of muscle mass based on chest high-resolution CT and its prognostic value for tuberculosis: a retrospective study

Objective This study aims to explore the prognostic value of quantitatively evaluating muscle mass using chest high resolution computed tomography (HRCT) in patients with active tuberculosis (TB). Methods This retrospective cohort study collected data from 309 patients with active TB diagnosed at Ningbo No.2 Hospital from 2020 to 2023. Based on the skeletal muscle index (SMI) at the T12 vertebra (with thresholds of 2 /m 2 for men and 2 /m 2 for women), patients were divided into a low muscle mass group and a normal muscle mass group. The study compared baseline characteristics, muscle mass-related indicators, body mass index (BMI), and imaging features between the two groups. The correlation between muscle mass-related indicators, BMI, and TB imaging features and prognosis was analyzed. Receiver operating characteristic (ROC) curve analysis and multivariate logistic regression were used to assess the prognostic value of muscle mass-related indicators and BMI in patients undergoing anti-TB treatment. Results A total of 309 patients were included in the study, divided into a normal muscle mass group ( n = 229) and a low muscle mass group ( n = 80). There was a significant difference in prognosis between the two groups ( χ 2 test, p p p p p β : - 4.56, 95% CI [-5.45 to -3.67]) and lesion absorption ratio ( β :0.036, 95% CI [0.031-0.041]). Multivariable logistic regression analysis demonstrated that after accounting for age, gender, T12 SMRA, T12 SMI was significantly associated with the prognosis of TB patients (OR: 20.10, 95% CI [8.81-51.56], p Conclusion Quantitative evaluation of muscle mass using chest HRCT, particularly the T12 SMI, may provide valuable prognostic information for tuberculosis patients, potentially offering advantages over BMI in assessing patient outcomes.