Parenchymal Cavitations in Pulmonary Tuberculosis: Comparison between Lung Ultrasound, Chest X-ray and Computed Tomography
This article aims to detect lung cavitations using lung ultrasound (LUS) in a cohort of patients with pulmonary tuberculosis (TB) and correlate the findings with chest computed tomography (CT) and chest X-ray (CXR) to obtain LUS diagnostic sensitivity. Patients with suspected TB were enrolled after...
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MDPI AG
2024-02-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/5/522 |
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| author | Diletta Cozzi Maurizio Bartolucci Federico Giannelli Edoardo Cavigli Irene Campolmi Francesca Rinaldi Vittorio Miele |
| author_facet | Diletta Cozzi Maurizio Bartolucci Federico Giannelli Edoardo Cavigli Irene Campolmi Francesca Rinaldi Vittorio Miele |
| author_sort | Diletta Cozzi |
| collection | DOAJ |
| description | This article aims to detect lung cavitations using lung ultrasound (LUS) in a cohort of patients with pulmonary tuberculosis (TB) and correlate the findings with chest computed tomography (CT) and chest X-ray (CXR) to obtain LUS diagnostic sensitivity. Patients with suspected TB were enrolled after being evaluated with CXR and chest CT. A blinded radiologist performed LUS within 3 days after admission at the Infectious Diseases Department. Finally, 82 patients were enrolled in this study. Bronchoalveolar lavage (BAL) confirmed TB in 58/82 (71%). Chest CT showed pulmonary cavitations in 38/82 (43.6%; 32 TB patients and 6 non-TB ones), LUS in 15/82 (18.3%; 11 TB patients and 4 non-TB ones) and CXR in 27/82 (33%; 23 TB patients and 4 non-TB ones). Twelve patients with multiple cavitations were detected with CT and only one with LUS. LUS sensitivity was 39.5%, specificity 100%, PPV 100% and NPV 65.7%. CXR sensitivity was 68.4% and specificity 97.8%. No false positive cases were found. LUS sensitivity was rather low, as many cavitated consolidations did not reach the pleural surface. Aerated cavitations could be detected with LUS with relative confidence, highlighting a thin air crescent sign towards the pleural surface within a hypoechoic area of consolidation, easily distinguishable from a dynamic or static air bronchogram. |
| first_indexed | 2024-04-25T00:32:35Z |
| format | Article |
| id | doaj.art-cb25c101913c49c29fe92391ef5c6c76 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-04-25T00:32:35Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-cb25c101913c49c29fe92391ef5c6c762024-03-12T16:42:02ZengMDPI AGDiagnostics2075-44182024-02-0114552210.3390/diagnostics14050522Parenchymal Cavitations in Pulmonary Tuberculosis: Comparison between Lung Ultrasound, Chest X-ray and Computed TomographyDiletta Cozzi0Maurizio Bartolucci1Federico Giannelli2Edoardo Cavigli3Irene Campolmi4Francesca Rinaldi5Vittorio Miele6Radiology Emergency Department, Careggi University Hospital, 50139 Florence, ItalyDepartment of Radiology, Azienda USL Toscana Centro, 59100 Prato, ItalyDepartment of Radiology, Azienda USL Toscana Centro, Mugello Hospital, 50032 Borgo San Lorenzo, ItalyRadiology Emergency Department, Careggi University Hospital, 50139 Florence, ItalyDepartment of Infectious and Tropical Diseases, Careggi University Hospital, 50134 Florence, ItalyDepartment of Infectious Diseases, Azienda Ospedaliero Universitaria Maggiore della Carità, 28100 Novara, ItalyRadiology Emergency Department, Careggi University Hospital, 50139 Florence, ItalyThis article aims to detect lung cavitations using lung ultrasound (LUS) in a cohort of patients with pulmonary tuberculosis (TB) and correlate the findings with chest computed tomography (CT) and chest X-ray (CXR) to obtain LUS diagnostic sensitivity. Patients with suspected TB were enrolled after being evaluated with CXR and chest CT. A blinded radiologist performed LUS within 3 days after admission at the Infectious Diseases Department. Finally, 82 patients were enrolled in this study. Bronchoalveolar lavage (BAL) confirmed TB in 58/82 (71%). Chest CT showed pulmonary cavitations in 38/82 (43.6%; 32 TB patients and 6 non-TB ones), LUS in 15/82 (18.3%; 11 TB patients and 4 non-TB ones) and CXR in 27/82 (33%; 23 TB patients and 4 non-TB ones). Twelve patients with multiple cavitations were detected with CT and only one with LUS. LUS sensitivity was 39.5%, specificity 100%, PPV 100% and NPV 65.7%. CXR sensitivity was 68.4% and specificity 97.8%. No false positive cases were found. LUS sensitivity was rather low, as many cavitated consolidations did not reach the pleural surface. Aerated cavitations could be detected with LUS with relative confidence, highlighting a thin air crescent sign towards the pleural surface within a hypoechoic area of consolidation, easily distinguishable from a dynamic or static air bronchogram.https://www.mdpi.com/2075-4418/14/5/522lung ultrasoundchest X-raytuberculosiscomputed tomographyinfection |
| spellingShingle | Diletta Cozzi Maurizio Bartolucci Federico Giannelli Edoardo Cavigli Irene Campolmi Francesca Rinaldi Vittorio Miele Parenchymal Cavitations in Pulmonary Tuberculosis: Comparison between Lung Ultrasound, Chest X-ray and Computed Tomography Diagnostics lung ultrasound chest X-ray tuberculosis computed tomography infection |
| title | Parenchymal Cavitations in Pulmonary Tuberculosis: Comparison between Lung Ultrasound, Chest X-ray and Computed Tomography |
| title_full | Parenchymal Cavitations in Pulmonary Tuberculosis: Comparison between Lung Ultrasound, Chest X-ray and Computed Tomography |
| title_fullStr | Parenchymal Cavitations in Pulmonary Tuberculosis: Comparison between Lung Ultrasound, Chest X-ray and Computed Tomography |
| title_full_unstemmed | Parenchymal Cavitations in Pulmonary Tuberculosis: Comparison between Lung Ultrasound, Chest X-ray and Computed Tomography |
| title_short | Parenchymal Cavitations in Pulmonary Tuberculosis: Comparison between Lung Ultrasound, Chest X-ray and Computed Tomography |
| title_sort | parenchymal cavitations in pulmonary tuberculosis comparison between lung ultrasound chest x ray and computed tomography |
| topic | lung ultrasound chest X-ray tuberculosis computed tomography infection |
| url | https://www.mdpi.com/2075-4418/14/5/522 |
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