Purpose
Tuberculosis (TB) is a worldwide infection that kills more than 1 million people a year.
Diagnosis is made through clinical-laboratoristic findings but imaging plays a key role in the management of these patients.
Usually,
the main radiological approach in these kindsof patients is through radiography and computed tomography (CT) of the chest.
The aim of this study:
- to show our preliminary results of a cohort of patients with suspected TB infection studied with lung ultrasound (LUS),
- to compare LUS findings with chest CT...
Methods & Materials
Patients: 33 (20 males,
13 females) with a median age of 40.5 years.
Period: from October 2017 to May 2018
All the patients were admitted to Infective Diseases Department of our Institute with suspected TB,
after being evaluated in the Emergency Department with a clinical-laboratoristicand radiological evaluation (chest X-ray and chest CT).
Lung ultrasound investigation was performed by a radiologist within 3 days after admission.
Immediately after,
ashort report on the observed findings,
their location and spatial extension was written.
LUS images and video-clips were...
Results
All patients underwent BAL that confirmed TB infection in 23/33 (70%).
LUS was negative in 3/33 patients (10.1%) because of the absence of subpleural alterations detectable with an ultrasound exam.
LUS was positive in 30/33 patients (90.9%).
In these patients,
we found:
parenchymal-subpleural consolidations in 25/30 (83.3%)
interstitial syndrome (b-lines,
comet-tail artifact) in 20/30 (66.7%)
pleural effusion with parenchymal atelectasis in 5/30 (16.7%)
cavitated areas in 6/30 (20%)
pleural empyema in 1/30 (3.33%)
miliary TB in 1/30 (3.33%)
Only in one patient,
we found multiple...
Conclusion
Most of the alterations found with LUS were non-specific and did not allow differential diagnosis with other pathologic pulmonary conditions.
But,
once detected TB alterations with a chest CT,
LUS could play a consistent role in the follow-up of peripheral lesions during antibiotic therapy.
Therefore,
LUS could be considered a valid,
non-invasive and cost-effective tool compared to chest CT in order to reduce radio-exposure in these patients,
often of young age.
References
1.
Philippe Glaziou,
Charalambos Sismanidis,
Katherine Floyd,
and Mario Raviglione.Global Epidemiology of Tuberculosis.Cold Spring Harb Perspect Med (2015).
2.
Wongwaisayawan S,
Suwannanon R,
Sawatmongkorngul S,
Kaewlai R.Emergency Thoracic US: The Essentials.Radiographics (2016); 36(3):640-59.
doi: 10.1148/rg.2016150064.
3.
Hew M,
Corcoran JP,
Harriss EK,
et al.The diagnostic accuracy of chest ultrasound for CT detected radiographic consolidation in hospitalised adults with acute respiratory failure: a systematic review.BMJ Open (2015)5(5):e007838.
4.
Lichtenstein D,
Mézière G,
Biderman P,
et al.The comet-tail artefact: an ultrasound sign of alveolar-interstitial syndrome.Am J Respir...
Personal Information
Dr.
Diletta Cozzi
Department of Emergency Radiology Careggi University Hospital
L.go Brambilla,
3
50134 Florence
Italy (IT)
[email protected]
Dr.
Federico Giannelli:Department of Emergency Radiology - Careggi University Hospital,
Florence
Dr.
Chiara Moroni:Department of Emergency Radiology - Careggi University Hospital,
Florence
Dr.
Edoardo Cavigli:Department of Emergency Radiology - Careggi University Hospital,
Florence
Dr.
Alessandra Bindi:Department of Emergency Radiology - Careggi University Hospital,
Florence
Dr.
F:rancesca Rinaldi:Department of Infective and Tropical Diseases- Careggi University Hospital,
Florence
Dr.
Pier Giorgio Rogasi:Department of Infective and Tropical Diseases- Careggi University...