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

Abstract

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. 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 (>15mm) 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. 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.