Key result
Pericardial pathology outperforms four other tests in diagnosing constrictive tuberculous pericarditis, achieving ~93% sensitivity.
Why the study?
The diagnosis of constrictive tuberculous pericarditis remains challenging, prompting an evaluation of five diagnostic tests using pericardial tissue.
Which diagnostic test provides the highest accuracy for detecting constrictive tuberculous pericarditis using pericardial tissue?
Observational (n=69)
Which diagnostic test provides the highest accuracy for detecting constrictive tuberculous pericarditis using pericardial tissue?
Answers are grounded in this paper and cite their sources.
Pathology remains the most accurate diagnostic test for constrictive tuberculous pericarditis using pericardial tissue, significantly outperforming traditional smears, cultures, and modern nucleic acid amplification tests.
BACKGROUND: The diagnosis of constrictive tuberculous pericarditis (TBP) remains challenging. This study aimed to evaluate 5 tests (acid-fast bacilli [AFB] smear, Mycobacterium tuberculosis [MTB] culture, Xpert MTB/RIF assay, CapitalBio Mycobacterium real-time PCR detection assay [CapitalBio assay], and pathology) for constrictive TBP using pericardial tissue. METHODS: We reviewed the case histories of patients with suspected constrictive TBP. We analyzed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of these assays. RESULTS: A total of 69 patients were included. The sensitivity, specificity, PPV, NPV, and AUC of AFB smear were 7.3%, 100.0%, 100.0%, 21.5%, and 0.54, respectively; those of culture were 23.6%, 100.0%, 100.0%, 25.0%, and 0.62, respectively; those of Xpert MTB/RIF were 52.7%, 100.0%, 100.0%, 35.0%, and 0.76, respectively; those of CapitalBio assay were 50.9%, 100.0%, 100.0%, 34.2%, and 0.75, respectively; and those of pathology were 92.7%, 92.9%, 98.1%, 76.5%, and 0.93, respectively. CONCLUSIONS: The validity of AFB smear and MTB culture remains low. Nucleic acid amplification tests can provide diagnostic efficacy for TBP but only moderately. The CapitalBio assay and Xpert MTB/RIF were considered similar for diagnosing TBP. Pathology showed the best diagnostic accuracy among the 5 tests.
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Yu et al. (2022) conducted an observational in Constrictive tuberculous pericarditis (n=69). Diagnostic tests (AFB smear, MTB culture, Xpert MTB/RIF, CapitalBio assay, pathology) was evaluated on Diagnostic accuracy (sensitivity, specificity, PPV, NPV, AUC). Pathology showed the highest diagnostic accuracy for constrictive tuberculous pericarditis among 5 tests, with a sensitivity of 92.7%, specificity of 92.9%, and AUC of 0.93.
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