Utility of spiral and cine CT scans in pediatric patients suspected of aspirating radiolucent foreign bodies

Abstract

To review our experience with spiral and cine CT imaging for the diagnosis of foreign body aspiration. Fifty-one consecutive pediatric patients suspected of aspirating radiolucent FBs underwent chest radiography and a 3-dimensional spiral CT scan with 12 also undergoing a cine CT scan within 24 hours before rigid bronchoscopy. Bronchoscopic and CT results were compared. Rigid bronchoscopy showed that FBs were present in the main bronchus or bronchus intermedius of 42 patients. Spiral CT scans localized airway FBs in these same 42 patients. In the remaining nine patients without FBs, six were true-negatives and three were false-positives on CT scan interpretation, making the overall sensitivity, specificity, accuracy, and positive and negative predictive values of CT scans 100% (95% confidence interval, 91%-100%), 66.7% (29%-92%), 94.1% (64%-99%), 93.3% (81%-98%), and 100% (54%-100%), respectively. The cine CT scan correctly diagnosed nine of 12 patients as true-positives and three as true-negatives with identification of air trapping and secondary lung changes. These findings suggest that CT scans may be used in airway FB management of pediatric patients, especially with diagnostic dilemmas, and further prospective evaluations should be considered to assess its overall efficacy.