title: Radiological patterns of childhood thoracic tuberculosis in a developed country: a single institution's experience on 217/255 cases.
abstract: The incidence of tuberculosis is increasing in the developed world and children in particular represent a high-risk group for developing the disease. The aim of this review is to analyse the spectrum of radiological signs as reported in the recent literature, in light of our series over a 15-year period, to pinpoint the most common radiological patterns in a developed country and to determine the role played by the different chest imaging techniques in diagnosis improvement. Lung TB was present in 217 out of 255 patients (85 %): 146 patients were under 5 years of age (76 under 2 years) and 71 over 5 years (41 over 10 years). We describe different patterns differentiating adolescents and young adults from infants and children. Adolescents and young adult tuberculosis are apical and cavitary. Thoracic TB in infants and children is characterized by lymph node and parenchymal disease. In 21 cases with lymphadenopathies without lymph-bronchial diffusion (age range 2 months-7 years), CT identified the Ghon focus in 16/21 cases; chest X-ray never identified the Ghon focus. In our series, pleural TB was present in 8 cases out of 146 under 5 years of age, 5 cases out of 76 under 2 years, and 18 cases out of 71 over 5 years. Radiologists should be aware of typical patterns of tuberculosis, to provide an early diagnosis.
authors.affiliation: Department of Imaging, Bambino Gesù Children Hospital, IRCCS, Rome, Italy. paolo.toma@opbg.net.
authors.forename: Paolo
authors.initials: P
authors.lastname: Tomà
authors.affiliation: Paediatrics and Infectious Disease, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Lancella
authors.affiliation: Department of Imaging, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Menchini
authors.affiliation: Department of Imaging, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Lombardi
authors.affiliation: Department of Imaging, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
authors.forename: Aurelio
authors.initials: A
authors.lastname: Secinaro
authors.affiliation: Paediatrics and Infectious Disease, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Villani
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D011829:Radiation Dosage; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: CT; Chest; Chest radiography; Children; MRI; Tuberculosis