Characterization and staging of hepatic tuberculosis via computed tomography and imaging changes following anti-tuberculosis treatment

Objective To classify CT images of HTB and investigate CT imaging changes in patients with HTB following anti-tuberculosis treatment. Methods We retrospectively collected first-admission clinical and CT imaging data and follow-up CT imaging data following anti-tuberculosis treatment from 75 patients diagnosed with HTB. The sample comprised 38 (50.7%) males and 37 (49.3%) females, with a median age of 25.0 (21.0, 34.5) years. CT images were classified according to liver anatomy, and clinical features were compared among different CT image types. CT imaging changes of hepatic tuberculosis in 40 patients who underwent anti-tuberculosis treatment were analyzed (follow-up duration: range 2–27 months, median 12 .0 [interquartile range 7.0, 19.3] months). Result For CT image type classification, 40 (53.3%) patients were classified as capsular type, 12 (16%) as parenchymal type, and 23 (30.7%) as mixed type. Parenchymal and mixed types showed a significantly higher proportion of elevated serum alanine transaminase, alkaline phosphatase, and γ-glutamyl transferase than the capsular type ( p < 0.05). Follow-up CT imaging after anti-tuberculosis treatment of 24 patients (60%) showed continuous improvement of lesions, whereas 16 patients (40%) showed a paradoxical response to anti-tuberculosis treatment, characterized by an initial increase in the size of the lesions or the emergence of new lesions. The two response groups did not differ significantly in sex, age, CT imaging classification, blood cell analysis, liver function, or T-lymphocyte count ( p > 0.05). Conclusion CT imaging of hepatic tuberculosis can be categorized into capsular, parenchymal, or mixed type. Parenchymal and mixed types are more likely to cause liver function damage. Anti-tuberculosis treatment can induce a paradoxical reaction in some patients, which can be demonstrated by CT examination; moreover, CT imaging allows the observation of lesion changes.