Imaging differences between drug-resistant and sensitive tuberculosis: A systematic review and meta-analysis
GAO Jinsong1, YAO Feng1, LI Jin1,3, ZHANG Jianhui1, Lei Mingsheng1,2
1. Zhangjiajie Hospital Affiliated to Hunan Normal University, Zhangjiajie 427000, China; 2. Jishou University Zhangjiajie College, Zhangjiajie 427000, China; 3. Medical College of Jishou University, Jishou 416000, China
Abstract：Objective Meta-analysis was used to evaluate the imaging characteristics of drug-resistant and sensitive tuberculosis and to analyze the differences. Methods We searched PubMed, Web of Science, and China National Knowledge Infrastructure using the following search terms: “multidrug-resistant tuberculosis”“computed tomography”“drug-sensitive tuberculosis”, in which the time limited was from the establishment of databases to March 2024. The experimental group comprised patients with confirmed drug-resistant tuberculosis based on pathogen or molecular biology criteria, while the control group consisted of individuals with drug-sensitive tuberculosis. Data extraction from the included literature encompassed details such as first author, publication year, drug resistance status, sample size, imaging features, etc. Quality assessment of the included studies was performed using the NOS scale. Meta-analysis was carried out using Stata MP 18 software. Begg′s and Egger′s tests were employed to evaluate publication bias. Results Ultimately, eleven articles were included in our analysis, comprising 1352 patients with drug-resistant tuberculosis and 1852 patients with sensitive tuberculosis. The results of meta-analysis showed that in the experimental group, the incidence of cumulative lesions ≥3 lung lobes (RR=1.32, 95%CI 1.26-1.39), the incidence of damaged lung (RR=5.02, 95%CI 3.59-7.01), and the incidence of cavities (RR=1.55, 95%CI 1.47-1.69), lung consolidation rate (RR=1.35, 95%CI 1.24-1.46), incidence of atectasis (RR=1.36, 95%CI 1.16-1.60), was higher than that of control group, and lesion absorption after treatment (RR=0.63, 95%CI 0.57-0.71) was lower than that of control group , the incidence of pleural effusion (RR=1.01, 95% CI 0.87-1.16) and the incidence of mediastinal lymph node enlargement (RR=1.09, 95% CI 0.94-1.26) showed no significant difference between the two groups. The funnel plot results indicated publication bias in three effect indicators: lesion distribution, lung consolidation, and mediastinal lymph node enlargement. Conclusion Drug-resistant tuberculosis differs from sensitive tuberculosis in the distribution of lesions, lesion morphology, dynamic changes in the disease, and changes in the mediastinal lymph nodes, which can help in early diagnosis.
2024, Vol. 21 
