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影像学表现与 Xpert MTB/RIF 检测对疑似肺结核患者的相关性。

Association of Radiological Findings with the Xpert MTB/RIF Test in Patients with Suspected Pulmonary Tuberculosis.

机构信息

Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

Setor de Tuberculose, Laboratório Municipal de Alvorada, Alvorada, Brazil.

出版信息

Lung. 2018 Dec;196(6):755-760. doi: 10.1007/s00408-018-0157-z. Epub 2018 Sep 3.

Abstract

PURPOSE

Tuberculosis (TB) treatment is often carried out empirically, based on clinical and radiological findings. Chest X-ray (CXR) has good sensitivity but poor specificity in TB diagnosis. Xpert MTB/RIF (Mycobacterium tuberculosis/Rifampicin) is increasingly used in many countries as the initial diagnostic test for TB. The aim of the present study was to evaluate the association of radiological findings with the Xpert MTB/RIF test in patients with suspected pulmonary TB.

METHODS

Cross-sectional study in an outpatient TB clinic. Sputum AFB smear, culture, Xpert MTB/RIF, and CXR were collected in patients with suspected pulmonary TB.

RESULTS

During the study period, 312 patients met the inclusion criteria and were included in the analysis. Among Xpert MTB/RIF-positive cases, the radiographic patterns were classified as typical of TB, compatible of TB, and normal in 78 (70.3%), 31 (27.9%), and 2 (1.8%) patients, respectively. CXRs were classified as typical of TB, compatible of TB, and normal in 20 (10.0%), 25 (12.4%), and 152 (75.6%) patients, respectively, in Xpert MTB/RIF-negative cases.

CONCLUSIONS

We found an association between radiographic patterns and Xpert MTB/RIF results in patients with suspected pulmonary TB. These results confirm the current recommended diagnosis algorithm.

摘要

目的

结核病(TB)的治疗通常是基于临床和影像学发现进行经验性治疗。胸部 X 光(CXR)在结核病诊断中具有良好的敏感性,但特异性较差。Xpert MTB/RIF(结核分枝杆菌/利福平)越来越多地在许多国家被用作结核病的初始诊断测试。本研究旨在评估疑似肺结核患者的影像学表现与 Xpert MTB/RIF 检测之间的相关性。

方法

在一家门诊结核病诊所进行横断面研究。在疑似肺结核患者中收集痰 AFB 涂片、培养、Xpert MTB/RIF 和 CXR。

结果

在研究期间,312 名符合纳入标准的患者被纳入分析。在 Xpert MTB/RIF 阳性病例中,影像学模式分别归类为典型结核病、疑似结核病和正常,分别为 78 例(70.3%)、31 例(27.9%)和 2 例(1.8%)。在 Xpert MTB/RIF 阴性病例中,CXR 分别归类为典型结核病、疑似结核病和正常,分别为 20 例(10.0%)、25 例(12.4%)和 152 例(75.6%)。

结论

我们发现疑似肺结核患者的影像学表现与 Xpert MTB/RIF 结果之间存在相关性。这些结果证实了当前推荐的诊断算法。

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