Eisenberg Ronald L, Heidinger Benedikt H
Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215.
Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215.
Acad Radiol. 2017 Jul;24(7):846-850. doi: 10.1016/j.acra.2016.12.012. Epub 2017 Jan 30.
The purpose of this study was to assess the frequency and spectrum of abnormalities on routine screening chest radiographs among inpatients and outpatients with "positive purified protein derivative (PPD)" in a large tertiary care academic medical center in a country with low prevalence of tuberculosis (TB).
The reports of all chest radiographs of general inpatients and outpatients referred for positive PPD (2010-2014) were evaluated for the frequency of evidence of active or latent TB and the spectrum of imaging findings. The results of additional chest radiographs and computed tomography scans were recorded, as were additional relevant clinical histories and symptoms.
Of the 2518 patients who underwent chest radiography for positive PPD, the radiographs were normal in 91.3%. The vast majority of the abnormal radiographs demonstrated findings consistent with old tuberculous disease. There were three cases (0.1%) of active TB, all of which were either recent immigrants from an endemic area or had other relevant histories or clinical symptoms suggestive of the disease.
Universal chest radiography in general inpatient and outpatient populations referred for positive PPD is of low yield for detecting active disease in a country with low prevalence of TB.
本研究旨在评估在一个结核病（TB）低流行国家的大型三级医疗学术中心，对“结核菌素纯蛋白衍生物（PPD）阳性”的住院患者和门诊患者进行常规胸部X线筛查时异常情况的频率和范围。
对所有因PPD阳性转诊的普通住院患者和门诊患者的胸部X线报告（2010 - 2014年）进行评估，以确定活动性或潜伏性TB证据的频率以及影像学表现范围。记录额外胸部X线和计算机断层扫描的结果，以及其他相关临床病史和症状。
在2518例因PPD阳性接受胸部X线检查的患者中，91.3%的X线片正常。绝大多数异常X线片显示与陈旧性结核疾病相符的表现。有3例（0.1%）活动性TB，所有病例均为近期来自流行地区的移民或有其他相关病史或临床症状提示患有该病。
在TB低流行国家，对因PPD阳性转诊的普通住院患者和门诊患者进行普遍胸部X线检查，对检测活动性疾病的收益较低。
