Department of Infectious Diseases, University of Bari "Aldo Moro", 70121 Bari, Italy.
Doctors with Africa, 35128 Padova, Italy.
Int J Environ Res Public Health. 2018 Oct 12;15(10):2235. doi: 10.3390/ijerph15102235.
: Chest ultrasound (CUS) has been shown to be a sensitive and specific imaging modality for pneumothorax, pneumonia, and pleural effusions. However, the role of chest ultrasound in the diagnosis of thoracic tuberculosis (TB) is uncertain. We performed a systematic search in the medical literature to better define the potential role and value of chest ultrasound in diagnosing thoracic tuberculosis. : To describe existing literature with regard to the diagnostic value of chest ultrasound in thoracic tuberculosis. : MEDLINE, EMBASE, and Scopus databases were searched for relevant articles. We included studies that used chest ultrasound for the diagnosis or management of any form of thoracic tuberculosis, including pulmonary, pleural, mediastinal, and military forms. : We identified five main fields of chest ultrasound application: (1) Detection, characterization, and quantification of TB; (2) detection of residual pleural thickening after evacuation; (3) chest ultrasound-guided needle biopsy; (4) identification of pathologic mediastinal lymph nodes in children; and (5) identification of parenchymal ultrasound patterns. Effusion was also detected, in early stages, with signs of organization in 24⁻100% of patients. A low to moderate (10⁻23%), false negative rate was reported for chest ultrasound-guided needle biopsy. CUS was able to identify mediastinal lymph nodes in as many as 67% of patients with negative chest radiography. : Very few studies with important methodological limitations analyze the role of chest ultrasound in the diagnosis of TB. The scarce available data suggests potential targets of future diagnostic or feasibility trials, such as the detection of tuberculosis⁻related pleural effusion, residual pleural thickening, lymphadenopathy, TB parenchymal patterns, or the use of CUS in biopsy guidance.
胸腔超声(CUS)已被证明是一种用于气胸、肺炎和胸腔积液的敏感和特异的影像学方法。然而,胸腔超声在诊断肺结核(TB)中的作用尚不确定。我们对医学文献进行了系统检索,以更好地确定胸腔超声在诊断肺结核中的潜在作用和价值。
描述胸腔超声在诊断肺结核中的诊断价值的现有文献。
在 MEDLINE、EMBASE 和 Scopus 数据库中搜索相关文章。我们纳入了使用胸腔超声诊断或管理任何形式的肺结核(包括肺、胸膜、纵隔和军事形式)的研究。
我们确定了胸腔超声应用的五个主要领域:(1)TB 的检测、特征和定量;(2)引流后残余胸膜增厚的检测;(3)胸腔超声引导下的针吸活检;(4)儿童病理性纵隔淋巴结的识别;(5)实质超声模式的识别。胸腔超声还可在早期检测到胸腔积液,有 24%至 100%的患者出现渗出液的组织化迹象。胸腔超声引导下的针吸活检的假阴性率为低到中度(10%至 23%)。CUS 能够在多达 67%的胸部 X 线摄影阴性的患者中识别纵隔淋巴结。
为数不多的具有重要方法学局限性的研究分析了胸腔超声在 TB 诊断中的作用。有限的可用数据提示了未来诊断或可行性试验的潜在目标,例如检测与结核病相关的胸腔积液、残余胸膜增厚、淋巴结病、TB 实质模式,或在活检引导中使用 CUS。