Comparison of ultrasound with plain radiography and CT for the detection of mediastinal lymphadenopathy in children with tuberculosis.
BACKGROUND
Lymphadenopathy, with or without parenchymal abnormality, is the radiological hallmark of primary tuberculosis (TB) in children. However, lymph node enlargement may pass undetected on plain chest radiographs. Ultrasonography provides complementary information to that obtained by radiographs.


OBJECTIVE
To assess the clinical value of US for the detection of mediastinal lymphadenopathy in children with a positive intradermal tuberculin test.


METHODS
Thirty-two children with a mean age of 6 years and a positive Mantoux test underwent chest radiography (frontal and lateral) and US (suprasternal and left parasternal access routes). Chest CT was performed at the discretion of the attending physician in six cases.


RESULTS
Eleven children had clinical symptoms and 90% a recent contact with a person with active TB. In 90.5% of children with chest radiographic images compatible with TB, coincident findings in the mediastinal US study were found. By comparison, 66.7% of those with normal chest radiography had evidence of mediastinal lymphadenopathy on the US scan. In all cases but one, US and CT findings agreed.


CONCLUSIONS
Mediastinal US is useful for the detection of enlarged lymph nodes in children with a positive tuberculin reaction and normal chest radiography.
Bosch-Marcet
Joaquim
J
Department of Paediatrics, Avda. Francesc Ribas s/n, Hospital General de Granollers, 08400 Granollers, Barcelona, Spain. 8543jbm@telefonica.net
Serres-Créixams
Xavier
X
Zuasnabar-Cotro
Amalia
A
Codina-Puig
Xavier
X
Català-Puigbó
Margarita
M
Simon-Riazuelo
José L
JL
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic; D013909:Thorax / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014388:Tuberculosis, Lymph Node / Q000000981:diagnostic imaging*; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging; D014463:Ultrasonography