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

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.

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%).

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%.

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.

This study was approved by the Ethics Committee of our University Hospital (rif. CEAVC 14,816).