Department of Radiology, School of Medicine, Makerere University, Kampala, Uganda.
Department of Radiology, St Francis Hospital Nsambya, Kampala, Uganda.
PLoS One. 2023 Sep 20;18(9):e0287621. doi: 10.1371/journal.pone.0287621. eCollection 2023.
Chest Ultrasound Scan (CUS) has been utilized in place of CXR in the diagnosis of adult pneumonia with similar or higher sensitivity and specificity to CXR. However, there is a paucity of data on the use of CUS for the diagnosis of childhood TB. This study aimed to determine the diagnostic accuracy of CUS for childhood TB. This cross-sectional study was conducted at the Mulago National Referral Hospital in Uganda. Eighty children up to 14 years of age with presumptive TB were enrolled. They all had CUS and CXR performed and interpreted independently by radiologists. The radiologist who performed the CXR was blinded to the CUS findings, and vice versa. Radiologists noted whether TB was likely or unlikely. A two-by-two table was developed to compare the absolute number of children as either TB likely or TB unlikely on CXR or CUS. This was used to calculate the sensitivity and specificity of CUS when screening for TB in children, with a correction to accommodate the use of CXR as a reference test. The sensitivity of CUS was 64% (95% CI 48.5%-77.3%), while its specificity was 42.7% (95% CI 25.5%-60.8%). Both the CUS and CXR found 29 children with a likelihood of TB, and 27 children unlikely to have TB. CUS met the sensitivity target set by the WHO TPP for Triage, and it had a sensitivity and specificity comparable to that of CXR.
胸部超声扫描 (CUS) 已在成人肺炎的诊断中替代 CXR，其对肺炎的敏感性和特异性与 CXR 相似或更高。然而，关于 CUS 用于诊断儿童结核病的数据很少。本研究旨在确定 CUS 对儿童结核病的诊断准确性。这是一项在乌干达穆拉戈国家转诊医院进行的横断面研究。共纳入 80 名年龄在 14 岁以下疑似结核病的儿童。所有患儿均进行 CUS 和 CXR 检查，由放射科医生独立进行解读。进行 CXR 的放射科医生对 CUS 结果不知情，反之亦然。放射科医生记录结核病是否可能或不太可能。制作了一个四格表，比较 CXR 或 CUS 上儿童结核病可能性大或可能性小的绝对数量。这用于计算 CUS 筛查儿童结核病的敏感性和特异性，并进行校正以适应 CXR 作为参考测试的使用。CUS 的敏感性为 64%（95%CI 48.5%-77.3%），特异性为 42.7%（95%CI 25.5%-60.8%）。CUS 和 CXR 均发现 29 名儿童结核病可能性大，27 名儿童结核病可能性小。CUS 达到了世卫组织分诊 TPP 设定的敏感性目标，其敏感性和特异性与 CXR 相当。
