Lung ultrasound (LUS) in pulmonary tuberculosis: correlation with chest CT and X-ray findings

Author(s):  
Federico Giannelli ◽  
Diletta Cozzi ◽  
Edoardo Cavigli ◽  
Irene Campolmi ◽  
Francesca Rinaldi ◽  
...  
2021 ◽  
Author(s):  
Federico Giannelli ◽  
Diletta Cozzi ◽  
Edoardo Cavigli ◽  
Irene Campolmi ◽  
Francesca Rinaldi ◽  
...  

Abstract Background The aim is to describe lung ultrasound (LUS) findings in a cohort of patients with suspected pulmonary tuberculosis (PTB) and compare them with computed tomography (CT) and chest x-ray (CXR) findings in order to evaluate the potentiality of LUS in TB diagnosis. Methods In this prospective study, 82 subjects with suspected TB were enrolled after being evaluated with CXR and chest CT. LUS was performed by blinded radiologists within 3 days after admission. A semiquantitative index was used: score 1 (lesions that extend for about 1 - 15% of the affected zone), score 2 (15 - 40%) and score 3 (40-100%).Results Microbiological analysis confirmed TB diagnosis in 58/82 (70.7%). CT was positive in all patients, LUS in 79/82 (96,3%) CXR in 78/82 (95,1%) and adding LUS and CXR in 100%. In PTB patients we found a great number of lungs zones with micronodules and with total findings than non-TPB patients (p<0,05). Overall LUS sensitivity was 80%, greater for micronodules (82%) and nodules (95%), lower for consolidation with air bronchogram (72%) and cavitations (33%). We reported 5 complicated pleural effusion at LUS, only 1 in CT. CXR overall sensitivity was 81%. Adding CXR and LUS findings we reported a sensitivity of 90%. Conclusion LUS could be considered a valid, non-invasive and cost-effective diagnostic tool especially in world regions where CT were not available, also in addiction with CXR. Trial Registration This study was approved by the Ethics Committee of our University Hospital (rif. CEAVC 14816).


2021 ◽  
Vol 8 ◽  
Author(s):  
Pierluigi Bracciale ◽  
Salvatore Bellanova ◽  
Cristiana Cipriani

Infective lung disease is a spectrum of pulmonary disorders with high prevalence in clinical practice. In the last decade, many studies focused on the clinical usefulness of lung ultrasound (LUS) in the management of patients presenting with dyspnea from infective lung disease. We report data on the methodological and standardized use of bedside LUS in the differential diagnosis of patients with acute dyspnea from infective lung diseases. We performed a cross-sectional study in 439 patients (160 women and 279 men, mean age 64.2 ± 11.5 years, age range 23–91 years) with infective lung diseases. A bedside LUS with a convex probe and chest X-ray were performed in all subjects. Chest CT was performed in a subgroup of patients, as clinically needed. We observed a statistically significant difference in the percentage of pleural effusion and pulmonary consolidation assessed by LUS, compared to X-ray (52.7 vs. 20%, respectively, p &lt; 0.05; 93.6 vs. 48.2%, p &lt; 0.001). The majority of the consolidations detected by LUS were mixed, hypo- and hyperechoic, lesions, with air bronchogram in 40% of cases. All findings assessed by LUS were confirmed by chest CT, when performed. We describe the actual role of LUS in the assessment of patients with infective lung disease. It has higher sensitivity compared to chest X-ray in the detection of pleural effusion. Consolidations from infective lung disease have mostly mixed echogenicity by LUS.


2018 ◽  
Vol 44 (2) ◽  
pp. 161-166 ◽  
Author(s):  
Irai Luis Giacomelli ◽  
Roberto Schuhmacher Neto ◽  
Edson Marchiori ◽  
Marisa Pereira ◽  
Bruno Hochhegger

ABSTRACT The objective of this systematic review was to select articles including chest X-ray or chest CT findings in patients who developed pulmonary tuberculosis following solid organ transplantation (lung, kidney, or liver). The following search terms were used: “tuberculosis”; “transplants”; “transplantation”; “mycobacterium”; and “lung”. The databases used in this review were PubMed and the Brazilian Biblioteca Virtual em Saúde (Virtual Health Library). We selected articles in English, Portuguese, or Spanish, regardless of the year of publication, that met the selection criteria in their title, abstract, or body of text. Articles with no data on chest CT or chest X-ray findings were excluded, as were those not related to solid organ transplantation or pulmonary tuberculosis. We selected 29 articles involving a collective total of 219 patients. The largest samples were in studies conducted in Brazil and South Korea (78 and 35 patients, respectively). The imaging findings were subdivided into five common patterns. The imaging findings varied depending on the transplanted organ in these patients. In liver and lung transplant recipients, the most common pattern was the classic one for pulmonary tuberculosis (cavitation and “tree-in-bud” nodules), which is similar to the findings for pulmonary tuberculosis in the general population. The proportion of cases showing a miliary pattern and lymph node enlargement, which is most similar to the pattern seen in patients coinfected with tuberculosis and HIV, was highest among the kidney transplant recipients. Further studies evaluating clinical data, such as immunosuppression regimens, are needed in order to improve understanding of the distribution of these imaging patterns in this population.


Author(s):  
Yale Tung Chen ◽  
Milagros Martí de Gracia ◽  
Maria Luz Parra Gordo ◽  
Silvia Ossaba Velez ◽  
Sergio Agudo-Fernández

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Micah L. A. Heldeweg ◽  
Jorge E. Lopez Matta ◽  
Mark E. Haaksma ◽  
Jasper M. Smit ◽  
Carlos V. Elzo Kraemer ◽  
...  

Abstract Background Lung ultrasound can adequately monitor disease severity in pneumonia and acute respiratory distress syndrome. We hypothesize lung ultrasound can adequately monitor COVID-19 pneumonia in critically ill patients. Methods Adult patients with COVID-19 pneumonia admitted to the intensive care unit of two academic hospitals who underwent a 12-zone lung ultrasound and a chest CT examination were included. Baseline characteristics, and outcomes including composite endpoint death or ICU stay > 30 days were recorded. Lung ultrasound and CT images were quantified as a lung ultrasound score involvement index (LUSI) and CT severity involvement index (CTSI). Primary outcome was the correlation, agreement, and concordance between LUSI and CTSI. Secondary outcome was the association of LUSI and CTSI with the composite endpoints. Results We included 55 ultrasound examinations in 34 patients, which were 88% were male, with a mean age of 63 years and mean P/F ratio of 151. The correlation between LUSI and CTSI was strong (r = 0.795), with an overall 15% bias, and limits of agreement ranging − 40 to 9.7. Concordance between changes in sequentially measured LUSI and CTSI was 81%. In the univariate model, high involvement on LUSI and CTSI were associated with a composite endpoint. In the multivariate model, LUSI was the only remaining independent predictor. Conclusions Lung ultrasound can be used as an alternative for chest CT in monitoring COVID-19 pneumonia in critically ill patients as it can quantify pulmonary involvement, register changes over the course of the disease, and predict death or ICU stay > 30 days. Trial registration: NTR, NL8584. Registered 01 May 2020—retrospectively registered, https://www.trialregister.nl/trial/8584


Author(s):  
Ryan C. Gibbons ◽  
Mark Magee ◽  
Harry Goett ◽  
James Murrett ◽  
Jessica Genninger ◽  
...  

Thorax ◽  
2010 ◽  
Vol 65 (10) ◽  
pp. 863-869 ◽  
Author(s):  
A. P. Ralph ◽  
M. Ardian ◽  
A. Wiguna ◽  
G. P. Maguire ◽  
N. G. Becker ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document