title: Comparison of ultrasound with plain radiography and CT for the detection of mediastinal lymphadenopathy in children with tuberculosis.
abstract: 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.
authors.affiliation: Department of Paediatrics, Avda. Francesc Ribas s/n, Hospital General de Granollers, 08400 Granollers, Barcelona, Spain. 8543jbm@telefonica.net
authors.forename: Joaquim
authors.initials: J
authors.lastname: Bosch-Marcet
authors.forename: Xavier
authors.initials: X
authors.lastname: Serres-Créixams
authors.forename: Amalia
authors.initials: A
authors.lastname: Zuasnabar-Cotro
authors.forename: Xavier
authors.initials: X
authors.lastname: Codina-Puig
authors.forename: Margarita
authors.initials: M
authors.lastname: Català-Puigbó
authors.forename: José L
authors.initials: JL
authors.lastname: Simon-Riazuelo
mesh_terms: 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