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