Abstract
Purpose.
To assess the clinical value of sonography for the follow‐up of mediastinal lymphadenopathy in children diagnosed with pulmonary tuberculosis (TB).
Methods.
We conducted a retrospective review of the medical records of 21 children (9 boys, 12 girls) with a mean age of 6 years (range, 7.4 months to 18 years) who had a positive intradermal tuberculin skin test. All patients underwent thorough history‐taking, physical examination, frontal and lateral chest radiographs, and sonographic study of the mediastinum. The mediastinum was accessed through the suprasternal and left parasternal approaches. The presence of 1 or more masses with an ovoid or round shape and hypoechoic appearance in the anterior or middle mediastinum was recorded. A comparison was made between the results of the sonographic examination of the mediastinum before administration of anti‐TB agents and after 3 months of treatment.
Results.
Pulmonary radiographic findings were suggestive of TB in 17 patients and were uncertain in 4 patients. Sonographic examination, however, detected mediastinal lymphadenopathy in all patients. A comparison of pretreatment mediastinal sonograms with those obtained after 3 months of anti‐TB treatment showed a marked reduction of lymph node involvement in 17 patients (80.9%). In the remaining 4 patients, mediastinal lymphadenopathy was still present.
Conclusion.
Mediastinal sonography appears to be a valuable tool for the diagnosis of TB and in the monitoring of response to treatment in children. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2007