Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
PLoS One. 2021 Jan 28;16(1):e0246371. doi: 10.1371/journal.pone.0246371. eCollection 2021.
Bronchoscopy using radial probe endobronchial ultrasound (EBUS) is performed when a peripheral lung lesion (PLL) is suspected to be malignant. However, pulmonary tuberculosis is diagnosed in some patients, and healthcare workers could therefore be exposed to tuberculosis if sufficient precautions are not taken. In this study, we examined the proportion of and factors associated with unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe EBUS.
This retrospective study included 970 patients who received bronchoscopy using radial probe EBUS between December 2015 and November 2018. Clinical, histological, radiological, and microbiological data were reviewed.
Pulmonary tuberculosis was diagnosed in 31 patients (3.2%) during bronchoscopy using radial probe EBUS. Patients with a lower age were significantly more likely to be diagnosed with tuberculosis than elderly patients (odds ratio [OR], 0.951; 95% confidence interval [CI], 0.924-0.978; P = 0.001). Among the various CT findings, a low HUs difference between pre- and post-enhanced CT (OR, 0.976; 95% CI, 0.955-0.996; P = 0.022), the presence of concentric cavitation (OR, 5.211; 95% CI, 1.447-18.759; P = 0.012), and the presence of satellite centrilobular nodules (OR, 22.925; 95% CI, 10.556-49.785; P < 0.001) were independently associated with diagnosis of tuberculosis.
The proportion of unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe EBUS was 3.2%. A higher risk was independently associated with a younger age and CT findings of a small difference in HUs between pre- and post-enhancement images, concentric cavitation, and the presence of a satellite centrilobular nodule.
当怀疑外周肺病变（PLL）为恶性时，会进行支气管镜下径向探头超声（EBUS）检查。然而，一些患者被诊断为肺结核，如果没有采取足够的预防措施，医务人员可能会接触到结核分枝杆菌。在这项研究中，我们检查了在使用径向探头 EBUS 进行支气管镜检查期间，意外暴露于结核分枝杆菌的比例和相关因素。
这项回顾性研究纳入了 2015 年 12 月至 2018 年 11 月期间接受支气管镜下径向探头 EBUS 检查的 970 例患者。回顾了临床、组织学、影像学和微生物学数据。
在使用径向探头 EBUS 进行支气管镜检查期间，31 例（3.2%）患者被诊断为肺结核。与老年患者相比，年龄较小的患者更有可能被诊断为结核病（优势比 [OR]，0.951；95%置信区间 [CI]，0.924-0.978；P=0.001）。在各种 CT 表现中，增强前后 CT 之间 HU 差值较小（OR，0.976；95%CI，0.955-0.996；P=0.022）、存在同心空洞（OR，5.211；95%CI，1.447-18.759；P=0.012）和卫星小叶中心结节（OR，22.925；95%CI，10.556-49.785；P<0.001）与结核病的诊断独立相关。
使用径向探头 EBUS 进行支气管镜检查时，意外暴露于结核分枝杆菌的比例为 3.2%。年龄较小和增强前后 CT 图像 HU 差值较小、同心空洞和卫星小叶中心结节的存在与较高的风险独立相关。
