To determine the correlation and agreement between of chest CT scan and chest x-ray findings among tuberculin skin positive children.
Ninety eight patient aged 6 months to 18 years old recruited were positive in tuberculin test with > 10 mm induratio. All received chest radiograph & chest CT scan as part of the routine TB work up. These plates were evaluated by 3 readers of the center blinded to the clinical diagnosis of the patient. An agreement among tuberculin skin test positive children with significant chest x-ray findings with the Chest CT scan results was made.
A total of 98 children met the inclusion criteria(49% males and 51% females)The commonly affected age group was between 4–5 years old and between 9 and 11 years old (27% each).There was good agreement between reader 1 and reader 2 in the interpretation of normal chest findings (kappa=70%,p < .001) and between reader 2 and reader 3 (Kappa=62.7%,p < .001) but was poor with reader 1 and reader 3 (kappa= 53.7%, p < .001). In the interpretation of a normal chest-CT scan, three readers had higher agreement beyond chance (kappa=93.7%, 87.5%, 93.8%, all p-values < .05 , Among the specific lesions in the ct scan , there was excellent agreement among the three readers regarding the interpretation of a granuloma kappa=100%,p < .001); and peribronchial lymh nodes (kappa=100%, p < .001). There is low agreement between CT scan and chest radiography in discriminating normal from a abnormal findings for reader 1 (kappa=9.5%); reader 2 (kappa=6.2%); and reader 3 (kappa=10.1%). Abnormal CT scans did not significantly correlate with those of x-ray films across the three readers.(kappa=6.4%,p = .46).
The correlation and agreement between chest ct scan and chest xray among tuberculin positive children was poor.Chest CT scan is more sensitive in confirming the diagnosis of Tuberculosis.
Majority of pediatric TB cases are under or over diagnosed. The advent of using chest CT scan confirm and establish the diagnosis of TB disease in children.
Beverly Delacruz, No Financial Disclosure Information; No Product/Research Disclosure Information