Abstract:

Objective To explore the diagnostic value of percutaneous lung biopsy guided by contrast-enhanced ultrasound for culture negative tuberculosis.Methods A total of 56 patients were recruited who were admitted to Shanghai Pulmonary Hospital Affiliated to Tongji University from Jan.2018 to Dec.2018 and were diagnosed to be bacterial negative presumptive pulmonary tuberculosis. All patients underwent contrast-enhanced ultrasound and ultrasound-guided percutaneous lung biopsy. The results of conventional ultrasound and contrast-enhanced ultrasound, the detection rate of necrosis, the positive rate of puncture biopsy, and the complications were analyzed.Results The positive rate of ultrasound-guided percutaneous lung biopsy among 56 patients was 78.6% (44/56), including 35 cases of tuberculosis(79.5%, 35/44), 2 cases of non-tuberculosis mycobacterium, 2 cases of lung cancer, 5 cases of pneumonia, 12 cases of negative results(confirmed by diagnostic anti-tuberculosis treatment).The detection rate of intralesional necrosis of pulmonary tuberculosis by contrast-enhanced ultrasonography (68.1%,32/47) was higher than that by conventional ultrasonography (36.2%,17/47). There was a significant difference between those two methods (χ ²=9.592, P=0.002). Complications occurred only in 1 case (1.8%, 1/56) as hemoptysis during ultrasound-guided percutaneous lung biopsy, while the amount of blood was around 20 ml, symptom relived after 30 minutes, no hemoptysis thereafter. Conclusion For culture negative presumptive pulmonary tuberculosis cases, contrast-enhanced ultrasound-guided percutaneous lung biopsy is an effective and safe method for the diagnosis of negative tuberculosis, which has high clinical application value.

Key words: Tuberculosis, Ultrasonography, interventional, Biopsy, needle, Evaluation studies, Contrast-enhanced ultrasound