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: Idris, Nafisah
Format: Thesis
Language:English
Published: 2020
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Online Access:http://eprints.usm.my/58933/1/NAFISAH%20BINTI%20IDRIS-24%20pages.pdf
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spelling my-usm-ep.589332023-08-06T08:13:32Z Lung ultrasound pattern in pulmonary tuberculosis 2020 Idris, Nafisah RC306-320.5 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, 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. 2020 Thesis http://eprints.usm.my/58933/ http://eprints.usm.my/58933/1/NAFISAH%20BINTI%20IDRIS-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution Universiti Sains Malaysia
collection USM Institutional Repository
language English
topic RC306-320.5 Tuberculosis
spellingShingle RC306-320.5 Tuberculosis
Idris, Nafisah
Lung ultrasound pattern in pulmonary tuberculosis
description 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.
format Thesis
qualification_level Master's degree
author Idris, Nafisah
author_facet Idris, Nafisah
author_sort Idris, Nafisah
title Lung ultrasound pattern in pulmonary tuberculosis
title_short Lung ultrasound pattern in pulmonary tuberculosis
title_full Lung ultrasound pattern in pulmonary tuberculosis
title_fullStr Lung ultrasound pattern in pulmonary tuberculosis
title_full_unstemmed Lung ultrasound pattern in pulmonary tuberculosis
title_sort lung ultrasound pattern in pulmonary tuberculosis
granting_institution Universiti Sains Malaysia
granting_department Pusat Pengajian Sains Perubatan
publishDate 2020
url http://eprints.usm.my/58933/1/NAFISAH%20BINTI%20IDRIS-24%20pages.pdf
_version_ 1776101246495621120