Airway stenosis in patients with tracheobronchial tuberculosis assessment with high resolution computed tomographic scanning and risk factor analysis

Xiaojuan Wu¹Gaoyan He¹Baolin Jia¹Yu Yao¹Gaowu Yan¹Bo Li¹Mingmei Zhu¹Xiaobin Luo¹Chaoping Wang¹Jie Zhao¹Xianzhi Du²Tao Zhu^1*

• ¹Suining Central Hospital, Suining, China
• ²Second Affiliated Hospital, Chongqing Medical University, Chongqing, China

Tracheobronchial tuberculosis (TBTB) is a special type of tuberculosis that often results in tracheobronchial stenosis. High-resolution computed tomography (HRCT) has been used to assess pulmonary disease, but is less commonly used to assess airway stenosis. This study aimed to assess airway stenosis using HRCT and identify predictors of airway stenosis in patients with TBTB. This retrospective study reviewed the records of patients with TBTB diagnosed between January 2017 and July 2024. The airway wall thickness (WT), ratio of airway wall thickness to total diameter (T/D ratio), and percentage wall area (WA%) in each bronchus were measured and calculated using HRCT. A total of 184 patients with TBTB and 206 controls were finally included in the analysis. The WT, T/D ratio, and WA% values in the carina, right and left main bronchi, middle section, right superior, middle lobar bronchus, and left superior lobar bronchus were higher in patients with TBTB than in controls. These values were also higher in patients with TBTB without pulmonary tuberculosis (PTB) than in those with PTB. In addition, diabetes mellitus, sputum acid-fast bacilli (AFB) positivity, and TBTB type (II, III, and IV) were independent predictors of TBTB-induced airway stenosis. Measuring airway WT using HRCT is useful for evaluating airway stenosis in patients with TBTB. Furthermore, airway stenosis in patients with TBTB without PTB was more severe than that in patients with concomitant PTB. Diabetes mellitus, sputum AFB positivity and the TBTB type were the main predictors of airway stenosis.