Journal List > Allergy Asthma Respir Dis > v.6(5) > 1102176

Allergy Asthma Respir Dis. 2018 Sep;6(5):241-247. Korean.
Published online September 28, 2018.  https://doi.org/10.4168/aard.2018.6.5.241
© 2018 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology
Chest radiographs and computed tomography scans in children with airway foreign body
Yu Mi Park,1 Kyunghoon Kim,1 Hye Jin Lee,1 Eu Kyoung Lee,2 Eun Ae Yang,1 Hwan Soo Kim,1 Yoon Hong Chun,1 Jong-Seo Yoon,1 Soo Ah Im,3 Hyun Hee Kim,1 and Jin Tack Kim1
1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
2Kaya Pediatrics, Seoul, Korea.
3Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Correspondence to: Eu Kyoung Lee. Kaya Pediatrics, 225 Bangbae-ro, Seocho-gu, Seoul 06561, Korea. Tel: +82-2-537-1118, Fax: +82-2-537-0017, Email: euneun99@gmail.com
Received December 27, 2017; Revised June 19, 2018; Accepted June 30, 2018.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).


Abstract

Purpose

This study aimed to evaluate the diagnostic value of radiologic findings in children with suspected foreign body aspiration.

Methods

A retrospective medical chart review was done on 32 children with suspected foreign bodies in terms of age, sex, symptoms, signs, bronchographic findings, and type and location of foreign bodies. The diagnostic value of radiography was analyzed: 29 with chest anteroposterior (AP) or posteroanterior (PA) view, 23 with chest lateral decubitus view, 27 with chest computed tomography (CT), 29 with chest AP, PA or chest lateral decubitus view, and 25 with bronchoscopy.

Results

As a measure for detecting foreign body aspiration, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of radiologic findings were: chest AP or PA view, 50%, 100%, 100%, 29.4%, and 58.6%, respectively; chest lateral decubitus view, 57.9%, 50.0%, 84.6%, 20.0%, and 56.5%, respectively; chest AP, PA or chest lateral decubitus view, 69.6%, 66.7%, 88.8%, 36.4%, and 69.0%, respectively; and chest CT, 100.0%, 85.7%, 95.2%, 100.0%, and 96.2%, respectively.

Conclusion

There is clinical benefit to take chest radiographs to diagnose foreign body aspiration. However, based on the results of this study, it may be not necessary to take chest lateral decubitus to diagnose foreign body aspiration. If chest radiographs show unilateral hyperinflation, foreign body aspiration can be diagnosed. In cases of normal chest radiography and history of a witnessed choking episode combined with positive signs, the diagnosis of airway foreign body aspiration should be made by using chest CT.

Keywords: X-ray computed tomography; Child; Foreign bodies

Tables


Table 1
Patient characteristics and clinical features (n= 32)
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Table 2
Foreign body removal method, type, and location of foreign body (n= 25)
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Table 3
The accuracy of radiologic findings in evaluation of suspected foreign bodies
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Table 4
Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of chest radiograph and chest CT for the diagnosis of bronchial foreign body according to various studies
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