Evaluation of interventional ultrasonography sampling in early diagnosis of superficial lymphatic tuberculosis

doi:10.3969/j.issn.1000-6621.2019.12.002

Abstract

Abstract:

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) guided percutaneous sampling in the early diagnosis of superficial lymph node tuberculosis. Methods A retrospective analysis was performed on patients with suspected superficial lymphatic tuberculosis admitted to the tuberculosis department of Shanghai Pulmonary Hospital from 2018.1.1-2018.12.31,who received lymph node puncture/biopsy guided by ultrasound. A total of 249 patients with complete record were enrolled, including 96 males and 153 females. The median age was 32 (16-82) years. Clinical data of patients were collected and a database was established to record the clinical characteristics of patients, the findings of interventional ultrasound and the result of pathological, bacteriological, and molecular biological examinations on the sampling tissues of lymph node. Then the diagnostic efficiency of interventional ultrasonography sampling was evaluated, data was analyzed with statistical methods. Results Two hundred and nineteen cases were diagnosed as lymphatic tuberculosis and 30 cases were diagnosed as non-TB. Using the final diagnostic results as reference standard, the sensitivity and specificity of pathology examination after interventional ultrasonography in the diagnosis of lymphatic tuberculosis were 86.76% (190/219) and 100.00% (190/190);that of bacteriological test were 31.51% (69/219) and 100.00% (69/69). The sensitivity and specificity of GeneXpert MTB/RIF in the diagnosis of lymphatic tuberculosis in 100 patients were 97.80% (89/91) and 100.00% (9/9). With the final diagnosis result as the gold standard, the overall sensitivity and specificity of interventional ultrasound guided sampling in the diagnosis of lymphatic tuberculosis were 97.72% (214/219) and 100.00% (30/30), respectively;The positive predictive value was 100.00% (214/214), and the negative predictive value was 85.71% (30/35),the coincidence rate was 97.99% (244/249) and the Kappa value was 0.91. Conclusion Interventional ultrasonography could be helpful for diagnosis of superficial lymphatic tuberculosis.

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

Wen-wen SUN,Yi ZHANG,Meng-jun SHEN,Hui-ming ZHU,Yin WNAG,Lin FAN. Evaluation of interventional ultrasonography sampling in early diagnosis of superficial lymphatic tuberculosis[J]. Chinese Journal of Antituberculosis, 2019, 41(12): 1241-1245. doi: 10.3969/j.issn.1000-6621.2019.12.002

Figures/Tables 2

References 15

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超声造影诊断	淋巴结结核		淋巴结恶性肿瘤		淋巴结反应性增生		淋巴结结节病
超声造影诊断	例数	检出率(%)	例数	检出率(%)	例数	检出率(%)	例数	检出率(%)
良性	217	87.15	2	0.80	8	3.21	2	0.80
恶性	2	0.80	18	0.00	0	0.00	0	0.00
合计	219	67.95	20	8.03	8	3.21	2	0.80

超声介入取材检测结果	临床最终诊断		敏感度 (%)	特异度 (%)	阳性预测值 (%)	阴性预测值 (%)	符合率 (%)	Kappa值
超声介入取材检测结果	结核例数	非结核例数	敏感度 (%)	特异度 (%)	阳性预测值 (%)	阴性预测值 (%)	符合率 (%)	Kappa值
阳性	214	0	97.72	100.00	100.00	85.71	98.00	0.91
阴性	5	30