comparison of digital chest x-ray and thoracic computed tomography scan in childhood tuberculosis

Background: imaging is the mainstay of diagnostic criteria in tuberculosis (tb) diagnosis, especially in children; however, the exact role of chest x-ray (cxr) and thoracic ct scan (tct) still remains controversial. the aim of this study is to compare digital chest x-ray and thoracic ct scan in childhood tuberculosis. materials and methods: in this retrospective comparative study, 38 children under 15 years old with proved diagnosis of tb who were admitted to massih daneshvari hospital during 2010 to 2012. digital chest x-ray and spiral thoracic ct was performed before starting medication. results: direct smear for acid-fast bacillus was positive only in 38%. positive tuberculin skin test was seen in 51% of the cases. chest x-ray was normal in 36.8% of children, while ct scan was negative only in 21%. overall sensitivity of thoracic ct scan and chest x-ray were 78.9% and 63.2%, respectively which show no significant difference. ct scan detected lymphadenopathy, nodule/nodular infiltration, collapse and pleural effusion/ thickening significantly better than chest x-ray; however, there was no significant difference between cxr and tct in detection rate of consolidation/ground glass opacity, bronchiectasis, cicatricial volume loss and cavity/abscess. conclusions: this study proposed that investigation of children suspicious of tuberculosis by digital chest x-ray is still of great value. it seems that thoracic ct scan in children suspected of tuberculosis infection can be limited only to investigation of complications in selected patients.