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. 2018 Oct 12;15(10):2235.
doi: 10.3390/ijerph15102235.

Potential Diagnostic Properties of Chest Ultrasound in Thoracic Tuberculosis-A Systematic Review

Francesco Di Gennaro  1   2 , Luigi Pisani  3   4 , Nicola Veronese  5 , Damiano Pizzol  6 , Valeria Lippolis  7 , Annalisa Saracino  8 , Laura Monno  9 , Michaëla A M Huson  10 , Roberto Copetti  11 , Giovanni Putoto  12 , Marcus J Schultz  13   14
Affiliations

Potential Diagnostic Properties of Chest Ultrasound in Thoracic Tuberculosis-A Systematic Review

Francesco Di Gennaro et al. Int J Environ Res Public Health. .

Abstract

Background: Chest ultrasound (CUS) has been shown to be a sensitive and specific imaging modality for pneumothorax, pneumonia, and pleural effusions. However, the role of chest ultrasound in the diagnosis of thoracic tuberculosis (TB) is uncertain. We performed a systematic search in the medical literature to better define the potential role and value of chest ultrasound in diagnosing thoracic tuberculosis. Aim: To describe existing literature with regard to the diagnostic value of chest ultrasound in thoracic tuberculosis. Methods: MEDLINE, EMBASE, and Scopus databases were searched for relevant articles. We included studies that used chest ultrasound for the diagnosis or management of any form of thoracic tuberculosis, including pulmonary, pleural, mediastinal, and military forms. Results: We identified five main fields of chest ultrasound application: (1) Detection, characterization, and quantification of TB; (2) detection of residual pleural thickening after evacuation; (3) chest ultrasound-guided needle biopsy; (4) identification of pathologic mediastinal lymph nodes in children; and (5) identification of parenchymal ultrasound patterns. Effusion was also detected, in early stages, with signs of organization in 24⁻100% of patients. A low to moderate (10⁻23%), false negative rate was reported for chest ultrasound-guided needle biopsy. CUS was able to identify mediastinal lymph nodes in as many as 67% of patients with negative chest radiography. Conclusions: Very few studies with important methodological limitations analyze the role of chest ultrasound in the diagnosis of TB. The scarce available data suggests potential targets of future diagnostic or feasibility trials, such as the detection of tuberculosis⁻related pleural effusion, residual pleural thickening, lymphadenopathy, TB parenchymal patterns, or the use of CUS in biopsy guidance.

Keywords: low-resource settings; lung ultrasound; tuberculosis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram. Abbreviations: Tuberculosis (TB) and ultrasound (US).
See this image and copyright information in PMC

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