Erem Geoffrey, Otike Caroline, Okuja Maxwell, Ameda Faith, Nalyweyiso Dorothy Irene, Bugeza Samuel, Mubuuke Aloysius Gonzaga, Kakinda Michael
Department of Radiology, School of Medicine, Makerere University, Kampala, Uganda.
Department of Radiology, St. Francis Hospital, Nsambya, Kampala, Uganda.
Pan Afr Med J. 2024 Nov 27;49:95. doi: 10.11604/pamj.2024.49.95.45265. eCollection 2024.
robust data on the utility of chest ultrasound scans (CUS) for triage and diagnosis of pediatric tuberculosis (TB) are lacking. Therefore, we aimed to compare CUS features to chest radiography (CXR), which is the recommended imaging modality in children with presumptive pulmonary tuberculosis (PTB).
eighty children ≤14 years of age with presumptive TB underwent CUS and CXR performed by two separate radiologists for each modality, who looked for the presence of consolidation, lymphadenopathy, and pleural effusion in both modalities. These were compared using Fisher's exact test for independence to determine whether there was a significant difference in the findings between the two modalities. Cohen's kappa coefficient was used to calculate the agreement between CXR and CUS. STATA version 15 was used for analysis.
the proportions of children with abnormal findings (consolidation, lymphadenopathy, and pleural effusions) on CUS were 65% (52/80) and 81.3% (65/80) on CXR. Sixty-two-point-five percent (62.5% (33/52)) of those with abnormal findings on CUS and 51.3% (33/65) on CXR were likely to have TB. The overall agreement for these characteristics was moderate (κ-0.42). The differences in the findings of consolidation and pleural effusion were not statistically significant on either CXR or CUS, whereas that of lymphadenopathy was statistically significant (P<0.001).
chest ultrasound scans detected more abnormalities in children with presumptive TB. Overall, the findings were comparable to those of CXR, except for lymphadenopathy. Ultrasound is a promising triage and diagnostic tool for pediatric TB.
缺乏关于胸部超声扫描（CUS）在儿童结核病（TB）分诊和诊断中效用的有力数据。因此，我们旨在将CUS特征与胸部X线摄影（CXR）进行比较，CXR是疑似肺结核（PTB）儿童推荐的成像方式。
80名年龄≤14岁的疑似结核病儿童接受了CUS和CXR检查，每种检查由两名不同的放射科医生进行，他们在两种检查方式中寻找实变、淋巴结病和胸腔积液的存在。使用Fisher精确独立性检验对这些结果进行比较，以确定两种检查方式的结果是否存在显著差异。使用Cohen卡方系数计算CXR和CUS之间的一致性。使用STATA 15版本进行分析。
CUS检查发现异常结果（实变、淋巴结病和胸腔积液）的儿童比例为65%（52/80），CXR为81.3%（65/80）。CUS检查发现异常结果的儿童中62.5%（33/52）以及CXR检查发现异常结果的儿童中51.3%（33/65）可能患有结核病。这些特征的总体一致性为中等（κ = 0.42）。CXR或CUS上实变和胸腔积液的检查结果差异无统计学意义，而淋巴结病的差异有统计学意义（P<0.001）。
胸部超声扫描在疑似结核病儿童中检测到更多异常。总体而言，除淋巴结病外，检查结果与CXR相当。超声是一种有前景的儿童结核病分诊和诊断工具。
