Preprint Communication Version 1 Preserved in Portico This version is not peer-reviewed

Parenchymal Cavitations in Pulmonary Tuberculosis: Comparison between Lung Ultrasound, Chest X-ray and Computed Tomography

Diletta Cozzi
* ORCID logo ,
Maurizio Bartolucci
,
Federico Giannelli
,
Edoardo Cavigli
,
Irene Campolmi
,
Francesca Rinaldi
,
Vittorio Miele
ORCID logo
Version 1 : Received: 21 January 2024 / Approved: 22 January 2024 / Online: 22 January 2024 (10:11:40 CET)

A peer-reviewed article of this Preprint also exists.

Cozzi, D.; Bartolucci, M.; Giannelli, F.; Cavigli, E.; Campolmi, I.; Rinaldi, F.; Miele, V. Parenchymal Cavitations in Pulmonary Tuberculosis: Comparison between Lung Ultrasound, Chest X-ray and Computed Tomography. Diagnostics 2024, 14, 522. Cozzi, D.; Bartolucci, M.; Giannelli, F.; Cavigli, E.; Campolmi, I.; Rinaldi, F.; Miele, V. Parenchymal Cavitations in Pulmonary Tuberculosis: Comparison between Lung Ultrasound, Chest X-ray and Computed Tomography. Diagnostics 2024, 14, 522.

Abstract

This article aims to detect lung cavitations using lung ultrasound (LUS) in a cohort of patients with pulmonary tuberculosis (TB) and correlate the findings with chest computed tomography (CT) and chest x-ray (CXR) to obtain LUS diagnostic sensitivity. Patients with suspected TB were enrolled after being evaluated with CXR and chest CT. A blinded radiologist performed LUS within 3 days after the admission at the Infectious Diseases Department. Finally, 82 patients were enrolled in the study. BAL confirmed TB in 58/82 (71%). Chest CT showed pulmonary cavitations in 38/82 (43.6%; 32 TB patients and 6 non-TB ones), LUS in 15/82 (18.3%; 11 TB patients and 4 non-TB ones) and CXR in 27/82 (33%; 23 TB patients and 4 non-TB ones). Patients with multiple cavitations were 12 detected at CT and only 1 at LUS. LUS sensitivity was 39.5%, specificity 100%, PPV 100%, NPV 65.7%. CXR sensitivity was 68.4% and specificity 97.8%. No false positive cases were found. LUS sensitivity is rather low as many cavitated consolidations do not reach the pleural surface. Aerated cavitations could be detected with LUS with relative confidence, highlighting a thin air-crescent sign towards the pleural surface within a hypoechoic area of consolidation, easily distinguishable from dynamic or static air-bronchogram.

Keywords

Lung Ultrasound; Chest x-ray; Tuberculosis; Computed Tomography; Infection

Subject

Medicine and Pharmacology, Pulmonary and Respiratory Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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