Clinical and imaging evaluation in children with congenital airway abnormalities

Abstract

Objective To analyse clinical and imaging characteristics of congenital airway abnormalities,and to guide the clinical diagnosis and reduce rate of missed diagnosis and misdiagnosis.Methods Clinical and imaging characteristics in children who had been diagnosed congenital airway abnormalities in Shengjing Hospital of China Medical University from 2005 to 2011 were reviewed and analysed retrospectively.Results Of 23 children,12 cases were male,11 cases were female,the age was from 1 month to 10 years,the average age was 32 months.The disease course was from 3 days to 3 months,an average was 18 days.Clinical manifestations were repeated coughing,wheezing,dyspnea and recurrent respiratory infection.Through the spiral CT and three dimensional reconstruction,enhanced CT examination,6 cases of tracheobronchial stenosis,3 cases of trachea and bronchus,1 case of dysplasia of the left pulmonary artery and vein,3 cases of pulmonary sequestration,4 cases of pulmonary cyst and 6 cases of pulmonary hypoplasia were found.Conclusion Missed diagnosis and misdiagnosis of congenital airway malformations often occurs.When the following features were observed,congenital airway malformations may be taken into account:persistent cough; repeated or persistent wheezing,treated ineffectively with anti-inflammatory agent and bronchodilators ; recurrent or persistent stridor; repeated pulmonary infections,dyspnea; repeated or persistent pneumonia in the same part and unexplainedly mediastinal shift in X ray chest radiography.Spiral CT three dimensional reconstruction and enhancement is of great value in diagnosis of airway malformation. Key words: Congenital airway malformation; Spiral CT; Three dimensional reconstruction; Children