Evaluation of Chest X-ray and Thoracic Computed Tomography in Patients with Suspected Tuberculosis

Indian J Pediatr. 2016 May;83(5):397-400. doi: 10.1007/s12098-015-1949-2. Epub 2015 Dec 3.

Abstract

Objective: To investigate if there is any correlation between positive findings detected by posterior-anterior (PA) chest radiograph and thoracic computerized tomography (CT) in cases with suspected lung tuberculosis (TB) due to positive tuberculin skin test (TST) results.

Methods: This is a retrospective evaluation of the medical files of patients who visited the Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine from 2006, through 2011 as outpatients and had positive TST (>15 mm) results.

Results: A total of 326 patients were included in the study; 45.7 % (n = 149) were girls, and the mean age was 9.0 ± 4.1 y (range: 1-17 y). In total, 14.4 % (n = 47) had TB findings, all of which were in the form of hilar lymphadenopathy. Among the 47 cases with TB findings in PA chest X-ray, 45 (95.7 %) also had findings in thoracic CT. Only 2 (4.3 %) patients had normal thoracic CT results although their PA chest X-ray results were positive.

Conclusions: Evaluation for pulmonary TB in children with positive isolated TSTs should be made primarily with PA chest X-ray. A routine thoracic CT scan is not necessary for asymptomatic patients with only hilar lymphadenopathy findings in PA chest radiographs.

Keywords: Chest X-ray; Children; Radiology; Tuberculin skin test; Tuberculosis.

MeSH terms

  • Adolescent
  • Child
  • Female
  • Humans
  • India / epidemiology
  • Lung / diagnostic imaging*
  • Lymphadenopathy* / diagnosis
  • Lymphadenopathy* / etiology
  • Male
  • Mycobacterium tuberculosis / isolation & purification*
  • Radiography, Thoracic / methods*
  • Retrospective Studies
  • Symptom Assessment / methods
  • Tomography, X-Ray Computed / methods*
  • Tuberculin Test / methods
  • Tuberculosis, Pulmonary* / complications
  • Tuberculosis, Pulmonary* / diagnosis
  • Tuberculosis, Pulmonary* / epidemiology
  • Tuberculosis, Pulmonary* / physiopathology