Diagnostic value of ultrasound-guided pleural puncture in suspected tuberculosis pleurisy

doi:10.3969/j.issn.1000-6621.2019.08.006

Abstract

Abstract:

Objective To compare and analyze the diagnostic value of pathological tissue and pleural effusion samples obtained by ultrasound-guided pleural puncture in suspected tuberculous pleurisy.Methods Two hundred and ninety-eight patients with suspected tuberculous pleurisy who were admitted to Xi’an Chest Hospital from January 2016 to May 2018 were retrospectively analyzed. Among them, 112 cases were clinically diagnosed as tuberculous pleurisy and 186 cases as non-tuberculous pleurisy. The specimens of pathological tissue and pleural effusions were obtained under the guidance of ultrasound, and the pathological sections of the biopsies were examined (“pathological examination”). The pleural effusions were cultured with Mycobacteria tuberculosis (concentrated collection method, liquid culture BACTEC MGIT 960 operating system, “MGIT 960 culture”). GeneXpert MTB/RIF detection (“GeneXpert detection”) and acid-fast bacillus staining smear examination (“smear examination”). The above-mentioned methods took clinically confirmed patients as reference criteria, and obtained their diagnostic sensitivity, specificity, positive predictive value, negative predictive value and Yoden index, in order to evaluate the effectiveness of various detection methods in the diagnosis of tuberculous pleurisy.Results The sensitivity of pathological examination, MGIT 960 culture, GeneXpert detection and smear examination were 41.96% (47/112), 73.21% (82/112), 58.93% (66/112) and 2.68% (3/112).The specificity was 99.46% (185/186), 100.00% (186/186), 100.00% (186/186) and 100.00% (186/186). The Yoden index was 0.41, 0.73, 0.59, 0.02.Conclusion The results showed that MGIT 960 culture with concentrated bacteria collection method had better sensitivity and specificity than other detection techniques and methods. The Yoden index was the highest, and had good clinical diagnostic value for tuberculous pleurisy.

Key words: Tuberculosis, pleural, Ultrasonography, interventional, Biopsy, needle, Specimen handling, Laboratory techniques and procedures, Comparative study

Yi HUANG,Han YANG,Xuan FENG,Yuan LIU,Yao-hui ZHANG,Qi ZHANG. Diagnostic value of ultrasound-guided pleural puncture in suspected tuberculosis pleurisy[J]. Chinese Journal of Antituberculosis, 2019, 41(8): 833-837. doi: 10.3969/j.issn.1000-6621.2019.08.006

Figures/Tables 1

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检测技术与方法	临床诊断		敏感度 (%)	特异度 (%)	阳性预测值 (%)	阴性预测值 (%)	约登指数
检测技术与方法	结核性胸膜炎 (112例)	非结核性胸膜炎 (186例)	敏感度 (%)	特异度 (%)	阳性预测值 (%)	阴性预测值 (%)	约登指数
病理检查			41.96	99.46	97.92	74.00	0.41
阳性	47^a	1^b
阴性	65^c	185^d
MGIT 960培养			73.21	100.00	100.00	86.11	0.73
阳性	82	0
阴性	30	186
GeneXpert检测			58.93	100.00	73.33	77.88	0.59
阳性	66	0
阴性	46	186
涂片检查			2.68	100.00	100.00	63.05	0.02
阳性	3	0
阴性	109	186

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