Abstract
PurposeSuspected airway foreign body aspiration (FBA) is a common event in paediatric emergency units, especially in children under 3 years of age. It can be a life-threatening event if not diagnosed promptly and accurately. The purpose of this study is to compare the diagnostic performance of an ultralow-dose CT (DLP of around 1 mGycm) with that of conventional radiographic methods (fluoroscopy and chest radiography of the airways) in the diagnosis of FBA children’s airways.MethodsRetrospective cross-sectional study. Data from 136 children were collected: 75 were examined with conventional radiographic methods and 61 with ultralow-dose CT. Effective doses were compared using independent t tests. The results of bronchoscopy, if performed, were used in creating contingency 2 × 2 tables to assess the diagnostic performance between modalities. An extra triple reading of all images was applied for this purpose.ResultsThe effective doses used in the ultralow-dose CT examinations were lower compared with those in conventional methods (p < 0.001). The median dose for CT was 0.04 mSv compared with 0.1 mSv for conventional methods. Sensitivity and specificity were higher for ultralow-dose CT than those for conventional methods (100% and 98% versus 33% and 96%) as were the positive and negative predicted values (90% and 100% versus 60% and 91%).ConclusionUltralow-dose CT can be used as the imaging of choice in the diagnosis of airway FBA in emergency settings, thereby avoiding concerns about radiation doses and negative bronchoscopy outcomes.
Highlights
Foreign body aspiration (FBA) is a common paediatric emergency
The purpose of this study was to compare the diagnostic performance of an ultralow-dose Computed tomography (CT) protocol (DLP of around 1 mGycm) dose equivalent to conventional radiographic methods in the diagnosis of FBA of the airways in children
There was a statistically significant difference in the effective dose used by ultralow-dose CT of the airways related to fluoroscopy and chest radiography (p < 0.001) (Fig. 1)
Summary
Foreign body aspiration (FBA) is a common paediatric emergency. According to the Centre for Disease Control in the USA, it is the fourth most common cause of death in children between 1 and 5 years of age [1]. Tracheobronchial FBA commonly occurs in children younger than 3 years of age. The degree of severity depends on the location where the FB is deposited in the airway and the size, shape and type of material aspirated. The symptoms and management vary depending on whether or not the event has been observed by the parents or caregivers. The diagnosis of airway FBA can be challenging in both situations. An early diagnosis is essential to avoid dramatic consequences such as death or irreversible lung/airway damage and to prevent complications
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