高分辨率成像和五年结核病接触结果
Hanif Esmail1,2,3, Anna K Coussens1,4,5, Friedrich Thienemann1,6
1Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa.
在症状出现多年前,可以使用PET/CT扫描检测出亚临床结核病 (TB) 疾病. 这一发现挑战了当前的结核病范式,并提出了新的结核病查策略.
科学领域:
- 传染性疾病 传染性疾病
- 放射学 放射学是一门学科.
- 公共卫生 公共卫生
背景情况:
- 结核病 (TB) 在临床潜伏阶段的进展尚未完全理解.
- 目前的结核病查方法可能会错过早期的疾病.
研究的目的:
- 通过使用先进的成像,调查亚临床结核病 (TB) 的存在和意义.
- 评估基线PET/CT发现对未来结核病诊断的预测价值.
主要方法:
- 250名艾滋病毒阴性成年人家庭接触的里芬辛耐药结核病患者接受了基线18F-Fluorodeoxyglucose正子辐射和计算机断层扫描 (PET/CT).
- 参与者在没有接受预防治疗的情况下,被监测平均4.7年培养阳性结核病.
- 基线PET/CT发现与培养阳性结核病的发展相关分析.
主要成果:
- 在基线时,23.6%的参与者显示PET/CT发现与结核病一致,其中11.6%被归类为亚临床结核病.
- 在基线PET/CT上患有亚临床结核病的个体被诊断为培养阳性结核病的可能性显著增加 (34.5%对1.9%).
- 密集查检测到结核病例错过了基于症状或X射线查策略.
结论:
- 亚临床结核病病变可以通过PET/CT检测到微生物或症状诊断前四年.
- 这些发现挑战了传统的潜伏/活跃结核病模型.
- 这些结果对改善结核病查和管理策略有重大影响.
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