Real‐time ultrasound evaluation of tuberculous pleural effusions

Martínez, O. Carazo; Serrano, B. Vargas; Romero, Rafael

doi:10.1002/jcu.1870170605

Cited by 18 publications

(8 citation statements)

References 10 publications

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“…In 1989 Martinez et al reported that winding bands were seen with sonography in 8 out of 21 (38%) patients with TP 18. In the present study we showed that 17 out of 87 (21.8%) patients had septation revealed by thoracic sonography.…”

Section: Discussionsupporting

confidence: 59%

Sonographic septation: a predictor of sequelae of tuberculous pleurisy after treatment

Lai

Weng

et al. 2009

Thorax

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Background: Findings in the literature have been quite conflicting with respect to predicting residual pleural thickening (RPT) in tuberculous pleurisy (TP). The aim of this study was to determine which sonographic feature of TP might help in predicting the development of RPT. Methods: Eighty-seven patients with TP were enrolled prospectively. The initial sonographic features were classified as anechoic, homogenously echogenic, complex non-septated and complex septated. The RPT level was measured 12 months after the start of antituberculosis (TB) treatment. Spirometry was performed 6 and 12 months after the start of anti-TB treatment. Results: A higher odds of an RPT level .10 mm was found in patients with positive TB bacillus culture in pleural fluid (OR, 20.9; 95% CI, 2.2 to 198.0) and a complex septated sonographic pattern (OR, 145.0; 95% CI, 22.3 to 942.3). A complex septated sonographic pattern can predict RPT with a sensitivity of 80%, specificity of 96%, positive predictive value of 84% and negative predictive value of 94%. Patients with an RPT level .10 mm had a lower forced vital capacity than those without (75.4% (9.2%) predicted vs 83.2% (9.5%) predicted, p,0.01) Conclusion: A complex septated sonographic pattern is a useful sign to predict an RPT level .10 mm 1 year after the start of anti-TB treatment. An RPT level .10 mm is associated with a high probability of decreased lung volumes. Therefore, the initial sonographic feature is beneficial in predicting the sequelae of TP after treatment.The incidence rate of tuberculosis (TB) in Taiwan was 67.38 per 100 000 people in 2006.1 Although prevalence and mortality rates have decreased with time owing to effective drug treatment, this infectious disease remains a serious public health issue because of its detrimental complications. Tuberculous pleurisy (TP) is one of the manifestations of TB and is present in 10% of all causes of TB in Taiwan. 2 Although updated therapeutic regimens can effectively control this infectious disease and minimise its sequelae, residual pleural thickening (RPT) has been found in about half of the patients. [3][4][5] We have previously shown that approximately 26% of patients with TP after treatment are complicated with RPT levels .10 mm.6 RPT may result in a decreased lung volume and then have important clinical repercussions. It is therefore important to identify the clinical and functional impairment resulting from RPT in patients with TP receiving anti-TB treatment. Thus, the aim of this prospective study was to investigate if sonographic features can serve as a predictor of patient outcomes 12 months after the start of anti-TB drug treatment. To the best of our knowledge, limited studies have been published regarding the evaluation of RPT and the associated impairment in treated TP patients by using the initial songraphic parameters.

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Section: Discussionsupporting

confidence: 59%

Sonographic septation: a predictor of sequelae of tuberculous pleurisy after treatment

Lai

Weng

et al. 2009

Thorax

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“…4,5 Pleural thickening and a complex septated pattern, with fibrinous strands in the pleural space producing a weblike or branching appearance, has been strongly associated with tuberculosis. [6][7][8] Chen et al 9 found a 96% specificity for tuberculous pleural effusions when differentiating between tuberculosis and malignancy.…”

Section: Discussionmentioning

confidence: 99%

Tuberculous pleural effusion

Zhai¹,

Lu²,

Shi³

2016

J. Thorac. Dis.

143

109

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“…As reported, tuberculous pleural effusions and empyema commonly had complex septated sonographic appearances. 6,[13][14][15] However, the differentiation between empyema and tuberculosis is easily made. Therefore, our objective was to focus on the lymphocyte-rich exudative pleural effusions.…”

Section: D a Bmentioning

confidence: 99%

Sonographic Septation in Lymphocyte-Rich Exudative Pleural Effusions

Chen

Hsu

et al. 2006

Journal of Ultrasound in Medicine

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Objective. The purpose of this study was to evaluate the role of the sonographic features of lymphocyte-rich exudative pleural effusions in the differential diagnosis of tuberculosis and lung cancer in an area with a high incidence of tuberculosis. Methods. Medical records of patients undergoing chest sonography between January 2003 and June 2005 (30 months) were reviewed retrospectively. The enrolled patients included 73 with lung cancer-related pleural effusions and 93 with tuberculous pleural effusions. The sonographic appearances of the pleural effusions were defined in terms of 4 patterns: anechoic, homogeneously echogenic, complex septated, and complex nonseptated. Results. Among the 73 lung cancer-related pleural effusions, there were sonographic appearances of an anechoic pattern in 11% (8/73), a complex septated pattern in 4% (3/73), and a complex nonseptated pattern in 85% (62/73). In 93 tuberculous pleural effusions, there were sonographic appearances of an anechoic pattern in 12% (11/93), a complex septated pattern in 47% (44/93), and a complex nonseptated pattern in 41% (38/93). Apparently, a complex septated pattern in the sonographic appearance of lymphocyte-rich pleural effusions is a useful diagnostic predictor for differentiating tuberculosis from lung cancer (95% confidence interval, -0.57 to -0.29). If we define the complex septated pattern in the sonographic appearance of lymphocyte-rich exudative pleural effusions as a predictor for tuberculous pleural effusions, we can achieve sensitivity, specificity, positive predictive value, negative predictive value, and positive likelihood ratio values of 47%, 96%, 94%, 59%, and 12, respectively. Conclusions. A complex septated pattern in the sonographic appearance is a useful predictor of tuberculosis in lymphocyte-rich exudative pleural effusions.

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Real‐time ultrasound evaluation of tuberculous pleural effusions

Cited by 18 publications

References 10 publications

Sonographic septation: a predictor of sequelae of tuberculous pleurisy after treatment

Sonographic septation: a predictor of sequelae of tuberculous pleurisy after treatment

Tuberculous pleural effusion

Sonographic Septation in Lymphocyte-Rich Exudative Pleural Effusions

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