肺部和腹部超声波对结核病的准确性:印度前性队列研究
Stefan Fabian Weber1,2,3, Rebecca Wolf1,3, Katharina Manten3,4
1Department for Infectious Disease and Tropical Medicine, University Hospital Heidelberg, Heidelberg, Germany.
PloS one
|September 3, 2025
概括
照顾点超声波 (POCUS) 对结核病 (TB) 的诊断具有中等的准确性,在某些发现上与胸部X射线相似. 虽然POCUS没有达到查目标,但可以提高结核病诊断算法,特别是在胸部X射线无法获得的地方.
科学领域:
- 医学成像
- 传染性疾病
- 诊断的准确性
背景情况:
- 结核病 (TB) 的诊断具有挑战性,特别是在资源较少的环境中,对结核病肺部超声波 (LUS) 的数据有限.
- 关于以超声波检测艾滋病毒相关结核病 (FASH) 的先前研究主要包括艾滋病毒感染者.
- 这项研究是迄今为止在结核病流行环境中评估LUS和FASH的最大队列,主要是HIV阴性参与者.
研究的目的:
- 评估肺部和腹部超声波的诊断准确性,以诊断印度第三级医院的结核病.
- 将超声波结果与C反应蛋白和胸部X射线 (CXR) 对结核病诊断进行比较.
- 探索结合临床和超声波发现的多变量模型,以提高诊断性能.
主要方法:
- 预计将有541名可能患有结核病的成年人接受综合超声波评估.
- 以菌根培养和PCR作为参考标准对个人和联合超声波结果的评估.
- 与C反应蛋白和胸部X射线 (CXR) 的比较;使用通用混合模型和随机森林的多变量建模.
主要成果:
- 用超声波检测艾滋病毒相关结核病 (FASH) 的集中评估显示中度敏感性 (51%) 和特异性 (70%).
- 对LUS的较大整合 (≥1厘米) 显示了与CXR相比的准确性,用于暗示可能的结核病.
- 预测模型显示诊断性能中等,AUC为0. 79.
结论:
- 治疗点超声波 (POCUS) 没有达到世卫组织作为独立结核病查测试的目标.
- 某些LUS发现的准确性与CXR相美,可以纳入结核病查的诊断算法.
- 未来的研究应该探索人工智能,以提高TB-POCUS的准确性和可访问性.
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