PDF(Pubmed)
Abstract：
UNASSIGNED: The optimal choice of protocol for diagnostic imaging in children with tuberculosis (TB) is a contemporary challenge due to the war in Ukraine, which potentially can create a steep rise in TB cases in Western Europe. We aimed to gather all primary research comparing imaging modalities and their diagnostic accuracies for pulmonary findings in children with suspected or confirmed pulmonary tuberculosis (PTB).
UNASSIGNED: We searched the databases PubMed and Embase using pre-specified search terms, for English- and non-English published and un-published reports from the period 1972 to 2022. We retrieved reports via citation search in excluded literature reviews and systematic reviews. Studies were eligible if most of the study population was between 0 and 18 years of age with confirmed or suspected PTB, and study participants had described diagnostic images from two or more different imaging modalities.
UNASSIGNED: A total of 15 studies investigated conventional chest X-Ray (CXR) and computed tomography (CT) in diagnosing PTB in children. Nine studies investigated the number of participants in where CT or CXR confirmed the diagnosis of TB, and all of them, including a total of 1244 patients, reported that findings compatible with TB were more frequently detected on CT than CXR. Only two studies did not include radiological findings as part of their diagnostic criteria for PTB, and combined they showed that CT diagnosed 54/54 (100 %) children with confirmed PTB, while CXR diagnosed 42/54 (78 %). Two studies compared magnetic resonance imaging (MRI) with CXR and showed that MRI diagnosed more children with PTB than CXR. One study reported a higher positive predictive value (PPV), sensitivity and specificity for PTB findings for MRI than CXR. One study compared CXR with high-kilovolt (high-kV) CXR, finding compatible sensitivity and specificity regarding confirmation of PTB. Two studies compared ultrasound (US) with CXR and found that US had a higher diagnostic yield and more often correctly identified consolidations, mediastinal LAP, and pleural effusion.
UNASSIGNED: CT showed a higher diagnostic accuracy for PTB findings than CXR, MRI and US, and should be the imaging modality of first choice when available. MRI had a higher sensitivity and specificity than CXR for LAP, pleural effusion, and cavitation. US was complimentary in initial diagnostic work-up and follow up. A diagnostic strategy for PTB in children according to local availability and expertise is proposed, as no evidence from this systematic review shows otherwise, in acknowledgement of the expertise in high TB-burdened countries. CT can be performed when in doubt, due to the higher diagnostic yield.
UNASSIGNED: We searched the databases PubMed and Embase using pre-specified search terms, for English- and non-English published and un-published reports from the period 1972 to 2022. We retrieved reports via citation search in excluded literature reviews and systematic reviews. Studies were eligible if most of the study population was between 0 and 18 years of age with confirmed or suspected PTB, and study participants had described diagnostic images from two or more different imaging modalities.
UNASSIGNED: A total of 15 studies investigated conventional chest X-Ray (CXR) and computed tomography (CT) in diagnosing PTB in children. Nine studies investigated the number of participants in where CT or CXR confirmed the diagnosis of TB, and all of them, including a total of 1244 patients, reported that findings compatible with TB were more frequently detected on CT than CXR. Only two studies did not include radiological findings as part of their diagnostic criteria for PTB, and combined they showed that CT diagnosed 54/54 (100 %) children with confirmed PTB, while CXR diagnosed 42/54 (78 %). Two studies compared magnetic resonance imaging (MRI) with CXR and showed that MRI diagnosed more children with PTB than CXR. One study reported a higher positive predictive value (PPV), sensitivity and specificity for PTB findings for MRI than CXR. One study compared CXR with high-kilovolt (high-kV) CXR, finding compatible sensitivity and specificity regarding confirmation of PTB. Two studies compared ultrasound (US) with CXR and found that US had a higher diagnostic yield and more often correctly identified consolidations, mediastinal LAP, and pleural effusion.
UNASSIGNED: CT showed a higher diagnostic accuracy for PTB findings than CXR, MRI and US, and should be the imaging modality of first choice when available. MRI had a higher sensitivity and specificity than CXR for LAP, pleural effusion, and cavitation. US was complimentary in initial diagnostic work-up and follow up. A diagnostic strategy for PTB in children according to local availability and expertise is proposed, as no evidence from this systematic review shows otherwise, in acknowledgement of the expertise in high TB-burdened countries. CT can be performed when in doubt, due to the higher diagnostic yield.
摘要：
UNASSIGNED：由于乌克兰战争，结核病（TB）儿童诊断成像方案的最佳选择是当代挑战，这可能会导致西欧结核病病例的急剧上升。我们旨在收集所有主要研究，比较影像学模式及其对疑似或确诊肺结核（PTB）儿童肺部发现的诊断准确性。
UNASSIGNED：我们使用预先指定的搜索词搜索数据库PubMed和Embase，从1972年到2022年的英语和非英语出版和未出版的报告。我们在排除文献综述和系统综述中通过引文检索检索报告。如果大多数研究人群年龄在0至18岁之间，确诊或疑似PTB，则研究合格。研究参与者描述了来自两种或两种以上不同成像模式的诊断图像.
未经证实：共有15项研究调查了常规胸部X线（CXR）和计算机断层扫描（CT）对儿童PTB的诊断。九项研究调查了CT或CXR证实结核病诊断的参与者数量，所有的人,包括1244名患者，据报道，与结核病相符的发现在CT上比在CXR上更常见。只有两项研究没有将放射学结果作为其PTB诊断标准的一部分。并结合他们显示CT诊断54/54（100％）患有确诊PTB的儿童，而CXR诊断为42/54（78％）。两项研究将磁共振成像（MRI）与CXR进行了比较，表明MRI诊断的PTB儿童多于CXR。一项研究报告了更高的阳性预测值(PPV)，MRI对PTB结果的敏感性和特异性优于CXR。一项研究将CXR与高千伏（高kV）CXR进行了比较，发现关于PTB确认的相容的敏感性和特异性。两项研究将超声（US）与CXR进行了比较，发现US具有更高的诊断率，并且更经常正确识别合并，纵隔LAP,和胸腔积液.
UNASSIGNED：CT对PTB发现的诊断准确性高于CXR，核磁共振和美国，并且在可用时应该是首选的成像模式。MRI对LAP的敏感性和特异性高于CXR，胸腔积液,和空化。美国在最初的诊断工作和后续行动中表示赞赏。根据当地的可用性和专业知识，提出了儿童PTB的诊断策略。正如这份系统审查没有证据表明的那样，承认高结核病负担国家的专门知识。有疑问时可以进行CT，由于较高的诊断产量。
UNASSIGNED：我们使用预先指定的搜索词搜索数据库PubMed和Embase，从1972年到2022年的英语和非英语出版和未出版的报告。我们在排除文献综述和系统综述中通过引文检索检索报告。如果大多数研究人群年龄在0至18岁之间，确诊或疑似PTB，则研究合格。研究参与者描述了来自两种或两种以上不同成像模式的诊断图像.
未经证实：共有15项研究调查了常规胸部X线（CXR）和计算机断层扫描（CT）对儿童PTB的诊断。九项研究调查了CT或CXR证实结核病诊断的参与者数量，所有的人,包括1244名患者，据报道，与结核病相符的发现在CT上比在CXR上更常见。只有两项研究没有将放射学结果作为其PTB诊断标准的一部分。并结合他们显示CT诊断54/54（100％）患有确诊PTB的儿童，而CXR诊断为42/54（78％）。两项研究将磁共振成像（MRI）与CXR进行了比较，表明MRI诊断的PTB儿童多于CXR。一项研究报告了更高的阳性预测值(PPV)，MRI对PTB结果的敏感性和特异性优于CXR。一项研究将CXR与高千伏（高kV）CXR进行了比较，发现关于PTB确认的相容的敏感性和特异性。两项研究将超声（US）与CXR进行了比较，发现US具有更高的诊断率，并且更经常正确识别合并，纵隔LAP,和胸腔积液.
UNASSIGNED：CT对PTB发现的诊断准确性高于CXR，核磁共振和美国，并且在可用时应该是首选的成像模式。MRI对LAP的敏感性和特异性高于CXR，胸腔积液,和空化。美国在最初的诊断工作和后续行动中表示赞赏。根据当地的可用性和专业知识，提出了儿童PTB的诊断策略。正如这份系统审查没有证据表明的那样，承认高结核病负担国家的专门知识。有疑问时可以进行CT，由于较高的诊断产量。
