Uzum Kazim, Karahan Okkes I, Dogan Sukru, Coşkun Abdulhakim, Topcu Faik
Department of Pediatrics, Medical Faculty, University of Erciyes, 38039 Kayseri, Turkey.
Eur J Radiol. 2003 Dec;48(3):258-62. doi: 10.1016/s0720-048x(03)00044-5.
The chest radiography and TCT findings in children who had contacted with adult family members with active pulmonary tuberculosis were compared. The contributions of thoracic computed tomography to the diagnosis of tuberculosis were investigated.
The children who were 0-16 years old (n=173) and children of families with an adult member which was diagnosed as pulmonary tuberculosis were evaluated. The children were considered in two groups based on the absence (n=125) or presence (n=48) of complaints and/or ambiguous symptoms such as lack of appetite, mild cough, sweating, history of lung infection, low body weight and those with suspicious chest radiography findings (12 cases) were included in this study. Asymptomatic patients (n=125) did not undergo TCT. Patients who had positive PPD skin tests only received isoniazid. If the TCT demonstrated enlarged lymph nodes or parenchymal lesions, minimally active pulmonary tuberculosis was diagnosed and antituberculous treatment was given.
TCT revealed lymph node enlargement or parenchymal lesions in 39 children (81.2%). Of the 12 children whose CXRs revealed suspicious lymph node enlargement and/or infiltration, five had normal findings in TCT whereas the initial findings were confirmed in the remaining seven. These data suggest that there is a correlation between the presence of ambiguous symptoms in exposed children and TCT findings; chest radiography and TCT findings do not yield parallel findings. All the patients who received anti-TB treatment were resolved in the control examinations.
In this study there is a correlation between presence of ambiguous symptoms and TCT findings, but the chest radiography and TCT findings do not yield harmony in exposed children with ambiguous symptoms (suspicious tuberculosis cases). These observations should be considered in children with symptoms similar to those of exposed children, but with no definite history of exposure. If similar TCT findings observed in such patients, treatment for tuberculosis should be considered.
比较接触活动性肺结核成年家庭成员的儿童的胸部X线摄影和TCT检查结果。研究胸部计算机断层扫描对结核病诊断的贡献。
对0至16岁的儿童（n = 173）以及有成年家庭成员被诊断为肺结核的家庭中的儿童进行评估。根据是否存在诸如食欲不振、轻度咳嗽、出汗、肺部感染史、体重减轻等主诉和/或模糊症状，将儿童分为两组，本研究纳入了无上述情况的儿童（n = 125）以及有上述情况的儿童（n = 48），还纳入了胸部X线摄影检查结果可疑的12例儿童。无症状患者（n = 125）未接受TCT检查。PPD皮肤试验呈阳性的患者仅接受异烟肼治疗。如果TCT显示淋巴结肿大或实质性病变，则诊断为轻度活动性肺结核并给予抗结核治疗。
TCT显示39名儿童（81.2%）有淋巴结肿大或实质性病变。在12名胸部X线摄影显示可疑淋巴结肿大和/或浸润的儿童中，5名TCT检查结果正常，而其余7名儿童的初始检查结果得到证实。这些数据表明，接触儿童中模糊症状的存在与TCT检查结果之间存在相关性；胸部X线摄影和TCT检查结果不一致。所有接受抗结核治疗的患者在对照检查中均康复。
在本研究中，模糊症状与TCT检查结果之间存在相关性，但胸部X线摄影和TCT检查结果在有模糊症状（可疑结核病例）的接触儿童中并不一致。对于有与接触儿童相似症状但无明确接触史的儿童，应考虑这些观察结果。如果在此类患者中观察到类似的TCT检查结果，则应考虑进行抗结核治疗。
