Lung ultrasound pattern in pulmonary tuberculosis
Background Pulmonary tuberculosis is a lethal transmissible airborne disease. There are various challenges in establishing diagnosis due to the low sensitivity of conventional bacteriological confirmation and limited accessibility to chest X-ray. These challenges result in a delay of diagnosis,...
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| Main Author: | |
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| Format: | Thesis |
| Language: | English |
| Published: |
2020
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| Subjects: | |
| Online Access: | http://eprints.usm.my/58933/1/NAFISAH%20BINTI%20IDRIS-24%20pages.pdf |
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| Summary: | Background
Pulmonary tuberculosis is a lethal transmissible airborne disease. There are various
challenges in establishing diagnosis due to the low sensitivity of conventional
bacteriological confirmation and limited accessibility to chest X-ray. These challenges
result in a delay of diagnosis, risking more populations being infected, resulting in overall
poor control of the disease. We aim to increase the diagnostic accuracy by introducing
the usage of lung ultrasound in combination with current diagnostic modalities. We
describe common lung ultrasound pattern seen in pulmonary tuberculosis and measure its
agreement with the routine screening imaging, that is chest X-ray.
Methods
A multicenter prospective cross-sectional study was conducted among confirmed
pulmonary tuberculosis patients aged above 18 years old. Lung ultrasound was performed
using a convex probe covering 14 lung sectors that covered the anterior, lateral and
posterior aspect of the lung. The pattern observed in pleura, subpleural and subcostal
space were described. The findings were also being compared with chest X-ray to find
the agreement between the two imaging modalities.
Findings
A total of 141 patients were recruited between January 2019 and February 2020. The
most frequent sector with findings was R1a seen in 92 (65.4%) patients, followed by R1b
seen in 88 (62.4%) patients. The most common zone with finding was right middle zone
observed in 112 (79.4%) patients. Pleural irregularity and subpleural consolidation were
observed in 139 (98.6%) and 125 (88.7%), respectively. There was a moderate Kappa
agreement between lung ultrasound and chest X-ray observed in all zones with a value
ranging from 0.46 to 0.59, with higher sensitivity observed for lung ultrasound.
Conclusion
The lung ultrasound pattern observed is in line with pulmonary tuberculosis pathology,
which involved the right upper and middle sector of the lung parenchyma. Lung
ultrasound showed higher sensitivity compared to chest X-ray especially when involving
right middle zone and right lower zone. |
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