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超声作为登革热的筛查工具并无用处。

Ultrasound is Not Useful as a Screening Tool for Dengue Fever.

作者信息

Parmar Jitendra, Mohan Chander, Kumar G Prem, Vora Maulik

机构信息

Department of Radiology, Dr. B. L. Kapur Hospital, New Delhi, India.

Department of Interventional Radiology, Dr. B. L. Kapur Hospital, New Delhi, India.

出版信息

Pol J Radiol. 2017 Nov 17;82:693-700. doi: 10.12659/PJR.902861. eCollection 2017.

Abstract

BACKGROUND

Dengue fever is a tropical disease that is transmitted by female Aedes Aegypti mosquitos. Early diagnosis is necessary to reduce the mortality and morbidity associated with the disease. A combination of clinical, laboratory, and sonography findings can be potentially helpful in making an early diagnosis of dengue fever. There is paucity of literature on the use of ultrasound for dengue fever screening; hence, the primary objective of the study was to evaluate the utility of ultrasound as a screening tool in dengue fever.

MATERIAL/METHODS: A total of 160 patients of suspected dengue fever were included in the study. They underwent ultrasound examinations in order to search for thickening of the gallbladder wall, pleural effusion, and ascites. On the basis of ultrasound findings, 65 cases were positive and 95 cases were negative for dengue fever. Serological tests were also used for diagnosing dengue fever, 93 cases were seropositive and 67 cases were seronegative. The ultrasonically diagnosed cases were compared with serologically diagnosed cases, and appropriate descriptive statistical analyses were applied.

RESULTS

The ultrasound findings included gall bladder wall thickening in 66 patients (41.2%). The sensitivity, specificity, and positive predictive value of ultrasound in diagnosing dengue fever were 58%, 84%, and 83%, respectively. The negative predictive value and accuracy were 59% and 68.8%, respectively.

CONCLUSIONS

The present study suggests that increased gall bladder wall thickness, pleural effusion, ascites, hepatomegaly, and splenomegaly are highly suggestive of dengue fever in clinically suspected cases. However, ultrasound should not be used as a screening tool, as negative ultrasound findings cannot rule out dengue fever due to the low sensitivity of this examination.

摘要

背景

登革热是一种由雌性埃及伊蚊传播的热带疾病。早期诊断对于降低与该疾病相关的死亡率和发病率至关重要。临床、实验室和超声检查结果相结合可能有助于早期诊断登革热。关于使用超声进行登革热筛查的文献较少;因此,本研究的主要目的是评估超声作为登革热筛查工具的效用。

材料/方法:本研究共纳入160例疑似登革热患者。他们接受了超声检查,以寻找胆囊壁增厚、胸腔积液和腹水。根据超声检查结果,65例登革热呈阳性,95例呈阴性。血清学检测也用于诊断登革热,93例血清学阳性,67例血清学阴性。将超声诊断的病例与血清学诊断的病例进行比较,并应用适当的描述性统计分析。

结果

超声检查结果显示66例患者(41.2%)胆囊壁增厚。超声诊断登革热的敏感性、特异性和阳性预测值分别为58%、84%和83%。阴性预测值和准确性分别为59%和68.8%。

结论

本研究表明,在临床疑似病例中,胆囊壁增厚、胸腔积液、腹水、肝肿大和脾肿大高度提示登革热。然而,超声不应作为筛查工具,因为由于该检查的低敏感性,超声检查结果为阴性不能排除登革热。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5464/5894038/77193bcde6d9/PJR-82-902861-g001.jpg

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