Abstract
There is a lack of standardized approach and terminology to classify the diverse spectrum of manifestations in tuberculosis. It is important to recognize the different clinical and radiographic patterns to guide treatment. As a result of changing epidemiology, there is considerable overlap in the radiologic presentations of primary tuberculosis and post-primary tuberculosis. In this article we promote a standardized approach in clinical and radiographic classification for children suspected of having or diagnosed with childhood tuberculosis. We propose standardized terms to diminish confusion and miscommunication, which can affect management. In addition, we present pitfalls and limitations of imaging. © 2017, The Author(s).
| Original language | English |
|---|---|
| Pages (from-to) | 1237-1248 |
| Number of pages | 12 |
| Journal | Pediatric Radiology |
| Volume | 47 |
| Issue number | 10 |
| Early online date | 29 Aug 2017 |
| DOIs | |
| Publication status | Published - Sept 2017 |
Bibliographical note
Cited By :1Export Date: 13 September 2017
CODEN: PDRYA
Correspondence Address: Andronikou, S.; Department of Paediatric Radiology, Bristol Royal Hospital for Children and the University of BristolUnited Kingdom; email: [email protected]
Funding details: University of Bristol
References: Marais, B.J., Gie, R.P., Simon Schaaf, H., A proposed radiological classification of childhood intra-thoracic tuberculosis (2004) Pediatr Radiol, 34, pp. 886-894. , PID: 15300340; Van Dyck, J., Vanhoenacker, F.M., Van den Brande, P., Imaging of pulmonary tuberculosis (2003) Eur Radiol, 13, pp. 1771-1785. , COI: 1:STN:280:DC%2BD3svgtlSkug%3D%3D, PID: 12942281; Graham, S.M., Ahmed, T., Amanullah, F., Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel (2012) J Infect Dis, 205, pp. S199-S208. , PID: 22448023; Moyo, S., Verver, S., Hawkridge, A., Tuberculosis case finding for vaccine trials in young children in high-incidence settings: a randomized trial (2012) Int J Tuberc Lung Dis, 16, pp. 185-191. , COI: 1:STN:280:DC%2BC387jslyjuw%3D%3D, PID: 22236918; Triasih, R., Robertson, C., De campo, J., An evaluation of chest x-ray in the context of community-based screening of child tuberculosis contacts (2015) Int J Tuberc Lung Dis, 19, pp. 1428-1434. , COI: 1:STN:280:DC%2BC28vlvFKqtw%3D%3D, PID: 26614182; Wang, X.W., Pappoe, F., Huang, Y., Xpert MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in children: a meta-analysis (2015) Clin Lab, 61, pp. 1775-1785. , COI: 1:CAS:528:DC%2BC28XntVKqsr4%3D, PID: 26732005; Ardizzoni, E., Fajardo, E., Saranchuk, P., Implementing the Xpert1MTB/RIF diagnostic test for tuberculosis and rifampicin resistance: outcomes and lessons learned in 18 countries (2015) PLoS One, 10. , PID: 26670929; (2013) Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF assay for the diagnosis of pulmonary and extrapulmonary TB in adults and children: policy update, , World Health Organization, Geneva; (2016) TB treatment for children, , https://www.cdc.gov/tb/topic/treatment/children.htm, Accessed 9 Jan 2017; Nahid, P., Dorman, S.E., Alipanah, N., Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America clinical practice guidelines: treatment of drug-susceptible tuberculosis (2016) Clin Infect Dis, 63, pp. e147-e195. , PID: 27516382; Lu-Fong, M.T., How, C.H., Bañez, M.A.P., (2003) Philippine pediatric Society handbook on childhood tuberculosis, , Quezon City, Philippines; Goodwin, R.A., Des Prez, R.M., Apical localization of pulmonary tuberculosis, chronic pulmonary histoplasmosis and progressive massive fibrosis of the lung (1983) Chest, 83, pp. 801-805. , COI: 1:STN:280:DyaL3s7otFKlsA%3D%3D, PID: 6839825; Leung, A.N., Muller, N.L., Pineda, P.R., Primary tuberculosis in childhood: radiographic manifestations (1992) Radiology, 182, pp. 87-91. , COI: 1:STN:280:DyaK38%2FotVOgug%3D%3D, PID: 1727316; Agrons, G.A., Markowitz, R.I., Kramer, S.S., Pulmonary tuberculosis in children (1993) Semin Roentgenol, 28, pp. 158-172. , COI: 1:STN:280:DyaK3s3ps1Ojsg%3D%3D, PID: 8516692; Miller, W.T., Miller, W.T., Jr., Tuberculosis in the normal host: radiological findings (1993) Semin Roentgenol, 28, pp. 109-118. , COI: 1:STN:280:DyaK3s3ps1Kqtw%3D%3D, PID: 8516687; Leung, A.N., Pulmonary tuberculosis: the essentials (1999) Radiology, 210, pp. 307-322. , COI: 1:STN:280:DyaK1M3itlyitw%3D%3D, PID: 10207408; Kim, W.S., Choi, J., II, Kim, I.-O., Pulmonary tuberculosis in infants: radiographic and CT findings (2006) AJR Am J Roentgenol, 187, pp. 1024-1033. , PID: 16985152; Perez-Velez, C.M., Marais, B.J., Tuberculosis in children (2012) N Engl J Med, 367, pp. 348-361. , COI: 1:CAS:528:DC%2BC38XhtFegsrvI, PID: 22830465; Lincoln, E.M., Sewell, E.M., (1963) Tuberculosis in children, pp. 1-315. , McGraw-Hill, New York; Wallgren, A., The time-table of tuberculosis (1948) Tubercle, 29, pp. 245-251. , COI: 1:STN:280:DyaH1M%2Fgt12itA%3D%3D, PID: 18101320; Lamont, A.C., Cremin, B.J., Pelteret, R.M., Radiological patterns of pulmonary tuberculosis in the paediatric age group (1986) Pediatr Radiol, 16, pp. 2-7. , COI: 1:STN:280:DyaL287itVSitw%3D%3D, PID: 3945496; Andronikou, S., Joseph, E., Lucas, S., CT scanning for the detection of tuberculous mediastinal and hilar lymphadenopathy in children (2004) Pediatr Radiol, 34, pp. 232-236. , PID: 14710313; Lee, K.S., Song, K.S., Lim, T.H., Adult-onset pulmonary tuberculosis: findings on chest radiographs and CT scans (1993) AJR Am J Roentgenol, 160, pp. 753-758. , COI: 1:STN:280:DyaK3s3gs1Omtg%3D%3D, PID: 8456658; McAdams, H.P., Erasmus, J., Winter, J.A., Radiologic manifestations of pulmonary tuberculosis (1995) Radiol Clin N Am, 33, pp. 655-678. , COI: 1:STN:280:DyaK2MzjsVGltA%3D%3D, PID: 7610237; Sanchez, M.O., Mendoza, A.R., Laya, B.F., Primary progressive tuberculosis in children: radiographic patterns in correlation with clinical presentation and microbiologic studies. St (2011) Luke’s J Med, 7, pp. 59-68; Griffith-Richards, S.B., Goussard, P., Andronikou, S., Cavitating pulmonary tuberculosis in children: correlating radiology with pathogenesis (2007) Pediatr Radiol, 37, pp. 798-804. , PID: 17530241; Kim, W.S., Moon, W.K., Kim, I.O., Pulmonary tuberculosis in children: CT evaluation (1997) AJR Am J Roentgenol, 168, pp. 1005-1009. , COI: 1:STN:280:DyaK2s3ktlehtw%3D%3D, PID: 9124105; Pulido, K.G.C., Laya, B.F., Villamor, C.P., Radiographic patterns of active pulmonary tuberculosis disease in Filipino pediatric patients and their correlation with symptoms, length of hospital confinement and clinical dispositions. St (2011) Luke’s J Med, 7, pp. 21-32; Tuddenham, W.J., Glossary of terms of thoracic radiology: recommendations of the nomenclature Committee of the Fleischner Society (1984) AJR Am J Roentgenol, 143, pp. 509-517. , COI: 1:STN:280:DyaL2c3nslejtQ%3D%3D, PID: 6380245; Kwong, J.S., Carignan, S., Kang, E.Y., Miliary tuberculosis: diagnostic accuracy of chest radiography (1996) Chest, 110, pp. 339-342. , COI: 1:STN:280:DyaK28zisF2qsw%3D%3D, PID: 8697830; Lee, K.S., Kim, Y.H., Kim, W.S., Endobronchial tuberculosis: CT features (1991) J Comput Assist Tomogr, 15, pp. 424-428. , COI: 1:STN:280:DyaK3M3isFaqtA%3D%3D, PID: 2026803; Weber, A.L., Bird, K.T., Janower, M.L., Primary tuberculosis in childhood with particular emphasis on changes affecting the tracheobronchial tree (1968) Am J Roentgenol Radium Therapy, Nucl Med, 103, pp. 123-132. , COI: 1:STN:280:DyaF1c3jslCquw%3D%3D; Laya, B.F., Concepcion, N.D.P., De la Eva, R.C., Computed tomography with multiplanar reformation and 3D-volume rendering technique in correlation with fiberoptic tracheobronchoscopy for thoracic evaluation of children with primary progressive tuberculosis and tracheobronchial involvement (2011) St Luke’s J Med, 7, pp. 11-20; Kashyap, S., Mohapatra, P.R., Saini, V., Endobronchial tuberculosis (2003) Indian J Chest Dis Allied, 45, pp. 247-256; Daly, J.F., Brown, D.S., Lincoln, E.M., Endobronchial tuberculosis in children (1952) Dis Chest, 22, pp. 380-398. , COI: 1:STN:280:DyaG3s%2Fhtlalug%3D%3D, PID: 12989007; Smith, L.S., Schillaci, R.F., Sarlin, R.F., Endobronchial tuberculosis: serial fiberoptic bronchoscopy and natural history (1987) Chest, 91, pp. 649-657; Lucas, S., Andronikou, S., Goussard, P., CT features of lymphobronchial tuberculosis in children, including complications and associated abnormalities (2012) Pediatr Radiol, 42, pp. 923-931. , PID: 22644456; Moon, W.K., Im, J.G., Yeon, K.M., Tuberculosis of central airways: CT findings of active and fibrotic disease (1997) AJR Am J Roentgenol, 169, pp. 649-653. , COI: 1:STN:280:DyaK2svitFOmsQ%3D%3D, PID: 9275870; Choyke, P.L., Sostman, H.D., Curtis, A.M., Adult-onset pulmonary tuberculosis (1983) Radiology, 148, pp. 357-362. , COI: 1:STN:280:DyaL3s3kvVWisQ%3D%3D, PID: 6867325; Yilmaz, M.U., Kumcuoglu, Z., Utkaner, G., CT findings of tuberculous pleurisy (1998) Int J Tuberc Lung Dis, 2, pp. 164-167. , COI: 1:STN:280:DyaK1c3itVGqtQ%3D%3D, PID: 9562128; Woodring, J.H., Vandiviere, H.M., Fried, A.M., Update: radiographic features of pulmonary tuberculosis (1986) AJR Am J Roentgenol, 146, pp. 497-506. , COI: 1:STN:280:DyaL287is1yiuw%3D%3D, PID: 3484866; Glicklich, M., Mendelson, D.S., Gendal, E.S., Tuberculous empyema necessitatis: CT findings (1990) Clin Imaging, 14, pp. 23-25. , COI: 1:STN:280:DyaK3c3htleiug%3D%3D, PID: 2322879; Kim, Y., Song, K.S., Goo, J.M., Thoracic sequelae and complications of tuberculosis (2001) Radiographics, 21, pp. 839-858. , COI: 1:STN:280:DC%2BD3MvgtVyjuw%3D%3D, PID: 11452057; Palmer, P.E., Pulmonary tuberculosis: usual and unusual radiographic presentations (1979) Semin Roentgenol, 14, pp. 204-242. , COI: 1:STN:280:DyaE1M3kvV2jsA%3D%3D, PID: 472765; Im, J.G., Webb, W.R., Han, M.C., Apical opacity associated with pulmonary tuberculosis: high-resolution CT findings (1991) Radiology, 178, pp. 727-731. , COI: 1:STN:280:DyaK3M7jsVenuw%3D%3D, PID: 1994409; Van den Brande, P., Demedts, M., Pulmonary tuberculosis in the elderly: diagnostic difficulties (1992) Eur J Med, 1, pp. 224-229. , COI: 1:STN:280:DyaK2c%2FotVegsA%3D%3D, PID: 1341449; Winer-Muram, H.T., Rubin, S.A., Thoracic complications of tuberculosis (1990) J Thorac Imaging, 5, pp. 46-63. , COI: 1:STN:280:DyaK3c3hvFWltg%3D%3D, PID: 2182903; Hadlock, F.P., Park, S.K., Awe, R.J., Unusual radiographic findings in adult pulmonary tuberculosis (1980) AJR Am J Roentgenol, 134, pp. 1015-1018. , COI: 1:STN:280:DyaL3c7nt1aqsg%3D%3D, PID: 6768239; Im, J.G., Itoh, H., Shim, Y.S., Pulmonary tuberculosis: CT findings — early active disease and sequential change with antituberculous therapy (1993) Radiology, 186, pp. 653-660. , COI: 1:STN:280:DyaK3s7lslGksg%3D%3D, PID: 8430169; Sochocky, S., Tuberculoma of the lung (1958) Am Rev Tuberc, 78, pp. 403-410. , COI: 1:STN:280:DyaG1M%2FgtV2hsA%3D%3D, PID: 13571599; De Villiers, R.V.P., Andronikou, S., Van de Westhuizen, S., Specificity and sensitivity of chest radiographs in the diagnosis of paediatric pulmonary tuberculosis and the value of additional high-kilovolt radiographs (2004) Australas Radiol, 48, pp. 148-153. , PID: 15230748; Laya, B.F., Thoracic tuberculosis in children: pitfalls and dilemma in chest radiograph interpretation. St (2011) Luke’s J Med, 7, pp. 69-76; Andronikou, S., van Hoenacker, F.M., de Backer, A.I., Advances in imaging chest tuberculosis: blurring of differences between children and adults (2009) Clin Chest Med, 30, pp. 717-744. , PID: 19925963
Keywords
- Children
- Computed tomography
- Ghon focus
- Progressive primary tuberculosis
- Radiography
- Tuberculosis
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