Diagnosticul radiologic al tuberculozei la copii: oportunități și limitări ale protocolului național.
DOI:
https://doi.org/10.52692/1857-0011.2025.3-83.27Cuvinte cheie:
tuberculoză pediatrică, radiografie, tomosinteză, tomografie computerizată, protocol național, diagnosticRezumat
Tuberculoza la copii rămâne o problemă majoră de sănătate publică, diagnosticul fiind complicat de sensibilitatea scăzută a metodelor microbiologice și tabloul clinic nespecific. În anul 2023, în Republica Moldova a fost aprobat Protocolul Clinic Național PCN-55, care accentuează importanța metodelor radiologice, inclusiv radiografia digitală, tomografia computerizată și tomosinteza digitală. Articolul analizează avantajele și limitările acestor metode în contextul protocolului și standardelor internaționale, subliniind necesitatea standardizării și instruirii continue a medicilor radiologi pentru optimizarea diagnosticului și tratamentului tuberculozei pediatrice în cadrul sistemului național de sănătate.
Referințe
Andronikou S. et al. Changes in the Role of Chest Radiographs for Diagnosing and Managing Children with Tuberculosis: The 2022 WHO Consolidated Guidelines on Tuberculosis. Pediatric Radiology, 2023, vol. 53, no. 3, pp. 566–570.
Bosch-Marcet J. et al. Value of Sonography for Follow- up of Mediastinal Lymphadenopathy in Children with Tuberculosis. Journal of Clinical Ultrasound, 2007, vol. 35, no. 3, pp. 118–124.
Casey Brian. Digital Tomosynthesis Works Well for Spinal Tuberculosis. AuntMinnie.com, 17 Apr. 2016.
Delacourt C., Mani T.M., Bonnerot V. et al. Computed tomography with normal chest radiograph in tuberculous infection. Archives of Disease in Childhood, 1993, vol. 69, pp. 430–432.
Gomez-Valverde J.J. et al. Chest X-Ray–Based Telemedicine Platform for Pediatric Tuberculosis Diagnosis in Low-Resource Settings: Development and Validation Study. JMIR Pediatrics and Parenting, 2024, vol. 7, no. 1, p. e51743.
Jiao Dan et al. Application of Digital Tomosynthesis in Diagnosing Spinal Tuberculosis. Clinical Imaging, 2016, vol. 40, no. 3, pp. 461–464.
Kulciţchi S., Iavorschi C., Tudor E., Chiosea L., Tomşa A., Formele clinice, depistarea și diagnosticul tuberculozei la copii în perioada pandemiei și postpandemică COVID-19. Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale, 2024, nr. 2(79), pp. 65–69. ISSN 1857-0011..
Mahomed N. et al. Tuberculosis revisted: classic imaging findings in childhood. Pediatric Radiology, 2023, vol. 53, no. 9, pp. 1799–1828.
Migliori G.B. et al. Worldwide Effects of Coronavirus Disease Pandemic on Tuberculosis Services, January– April 2020. Emerging Infectious Diseases, 2020, vol. 26, no. 11, pp. 2709–2712.
Ministerul Sănătății al Republicii Moldova. Protocol clinic național „Tuberculoza la copil” (ediția V). Chișinău, 2023, 217 p.
Mok Jeongha et al. Role of Digital Tomosynthesis in the Context of Tuberculosis Contact Investigation: Comparisons with Digital Radiography. Acta Radiologica, 2022, vol. 63, no. 7, pp. 901–908.
Nachiappan A.C. et al. Pulmonary Tuberculosis: Role of Radiology in Diagnosis and Management. RadioGraphics, 2017, vol. 37, no. 1, pp. 52–72.
Palmer M., Seddon, J.A., Goussard, P., Schaaf, H.S. Diagnostic CXR atlas for tuberculosis in children. The International Union Against Tuberculosis and Lung Disease, 24 Mar. 2022. https://theunion.org/technical-publications/diagnostic-cxr-atlas-for-tuberculosis-in-children.
Pisarenco N. Inteligența artificială în diagnosticul radiologic al bolilor pulmonare. Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale, 2024, nr. 2(79), pp. 188–192. DOI:
Pisarenco N. Rolul și locul tomosintezei în diagnosticul bolilor pulmonare. Buletinul Academiei de Ştiinţe a Moldovei. Ştiinţe Medicale, 2019, nr. 3(63), pp. 260– 265.
Pisarenco N. Tomosinteza digitală în diagnosticul și monitorizarea tuberculozei organelor respiratorii. Moldovan Medical Journal, 2018, no. 61(S_RMI), p. 84.
Pisarenco N. Digital tomosynthesis in the diagnosis and monitoring of pulmonary tuberculosis. National Congress on Respiratory Diseases, 16–19 oct. 2018, ed. 28, Moscow: DizainPress, 2018, pp. 87–88.
Qin Z.Z. et al. Tuberculosis Detection from Chest X-Rays for Triaging in a High Tuberculosis-Burden Setting: An Evaluation of Five Artificial Intelligence Algorithms. The Lancet Digital Health, 2021, vol. 3, no. 9, pp. e543–e554.
Reyna R. et al. Imaging Findings in ТБ. The Radiology Assistant, 2017. https://radiologyassistant.nl/chest/ТБ/tuberculosis.
Sharma Mandeep S. et al. Role of Digital Tomosynthesis and Dual Energy Subtraction Digital Radiography in Detection of Parenchymal Lesions in
Active Pulmonary Tuberculosis. European Journal of Radiology, 2015, vol. 84, pp. 1820–1827.
Sodhi K.S. et al. Rapid Lung MRI in Children with Pulmonary Infections: Time to Change Our Diagnostic Algorithms. Journal of Magnetic Resonance Imaging, 2016, vol. 43, no. 5, pp. 1196–1206.
The Union (International Union Against Tuberculosis and Lung Disease). Diagnostic CXR Atlas for Tuberculosis in Children: A Guide to Chest X-ray Interpretation. 2nd ed. Paris, 2022.
Vîlc V. et al. Valoarea tomografiei computerizate (CT) în diagnosticul tuberculozei la copii. Analele Ştiinţifice ale USMF „N. Testemițanu”, 2010, no. 3(11), pp. 294–300.
World Health Organization. Global Tuberculosis Report 2021. WHO TB guidelines: recent updates. https://www.who.int/publications/digital/global-tuberculosis-report-2021/featured-topics/tb-guidelines#:~:text=the%20screening%20of%20TB%20disease.
World Health Organization. Global Tuberculosis Report 2021. WHO TB guidelines: recent updates. Geneva: WHO. https://www.who.int/publications/digital/global-tuberculosis-report-2021/featured-topics/tb-guidelines#:~:text=the%20screening%20of%20TB%20disease.
World Health Organization. Global Tuberculosis Report 2024. Geneva: WHO, 2024.
World Health Organization. WHO Consolidated Guidelines on Tuberculosis: Module 5: Management of Tuberculosis in Children and Adolescents. Geneva: WHO, 2022.
World Health Organization. WHO Consolidated Guidelines on Tuberculosis: Module 2: Systematic Screening for Tuberculosis Disease. Geneva: WHO, 2021.
World Health Organization. WHO Consolidated Guidelines on Tuberculosis. Module 3: Diagnosis. Geneva: WHO, 2025.
World Health Organization. WHO consolidated guidelines on tuberculosis module 5: management of tuberculosis in children and adolescents. Geneva: WHO, 2022. https://www.who.int/publications/i/item/9789240046764.
World Health Organization. WHO consolidated guidelines on tuberculosis: module 3: diagnosis: rapid diagnostics for tuberculosis detection. Geneva: WHO, 2021, update. https://iris.who.int/bitstream/handle/10665/342331/9789240029415-eng.pdf.
Yavorskiy K.et al. The Significance of Computed Tomography in Diagnosing Pediatric Tuberculosis. IFMBE Proceedings: 6th International Conference on Nanotechnologies and Biomedical Engineering, 20–23 sept. 2023, Chişinău. Vol. 91. Springer Science and Business Media, 2024, pp. 376–385.
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