Comparative diagnostic efficacy of ultrasound-guided, medical thoracoscopic, and blind pleural biopsy in tuberculous pleurisy

MTPB is the optimal initial diagnostic method for suspected tuberculous pleurisy due to superior sensitivity. USPB, offering moderate accuracy with lower invasiveness, is a viable alternative if MTPB is unavailable. BPB should only be considered in resource-limited settings, with explicit recognition of its elevated false-negative risk necessitating rigorous clinical follow-up to prevent diagnostic delays. This study provides evidence-based guidance for selecting PB techniques.