Ruby Lisa C, Heuvelings Charlotte Carina, Grobusch Martin Peter, Andronikou Savvas, Bélard Sabine
Department of Paediatric Pulmonology, Immunology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands.
Paediatr Respir Rev. 2022 Mar;41:40-48. doi: 10.1016/j.prrv.2020.11.002. Epub 2020 Dec 9.
Diagnosing childhood tuberculosis (TB) is challenging, and novel diagnostic tools are urgently needed. Mediastinal lymphadenopathy is a hallmark of primary pulmonary TB (PTB) in children. We aimed to summarise available methodological and diagnostic data of transthoracic mediastinal ultrasound for childhood TB. Literature review identified two prospective and three retrospective studies, a case report, and a technical report including cases. All reported on suprasternal scanning of the mediastinum; additional parasternal scanning was reported by five studies. The proportion of children with lymphadenopathy detected by mediastinal ultrasound ranged between 15% and 85%, with studies including both supra- and parasternal scanning achieving higher detection ratios. Three retrospective studies reported mediastinal lymphadenopathy on ultrasound for most cases presenting with a normal or inconclusive CXR. Data on ultrasound for mediastinal lymphadenopathy in children are limited but indicate that mediastinal ultrasound can successfully detect mediastinal lymphadenopathy in children with TB.
诊断儿童结核病具有挑战性，因此迫切需要新型诊断工具。纵隔淋巴结肿大是儿童原发性肺结核（PTB）的一个标志。我们旨在总结经胸纵隔超声用于儿童结核病的现有方法学和诊断数据。文献综述确定了两项前瞻性研究、三项回顾性研究、一份病例报告以及一份包含病例的技术报告。所有研究均报告了经胸骨上窝对纵隔进行扫描的情况；五项研究还报告了经胸骨旁进行额外扫描的情况。经纵隔超声检测出淋巴结肿大的儿童比例在15%至85%之间，同时包括胸骨上窝和胸骨旁扫描的研究检测率更高。三项回顾性研究报告称，对于大多数胸部X线检查正常或结果不明确的病例，超声检查发现了纵隔淋巴结肿大。关于儿童纵隔淋巴结肿大的超声检查数据有限，但表明纵隔超声能够成功检测出患有结核病儿童的纵隔淋巴结肿大。
