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Evaluation of computed tomography virtual bronchoscopy in paediatric tracheobronchial foreign body aspiration

Published online by Cambridge University Press:  29 April 2010

K V Bhat*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
J S Hegde
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
U S Nagalotimath
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
G C Patil
Affiliation:
Department of Radiodiagnosis, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
*
Address for correspondence: Dr K Vikram Bhat, 102 Arvind Apartments, Kalyan-nagar, Hubli 580031, Karnataka, India. E-mail: vikram.ent@gmail.com

Abstract

Objective:

Virtual bronchoscopy is a noninvasive technique which provides an intraluminal view of the tracheobronchial tree. This study aimed to evaluate this technique in comparison with rigid bronchoscopy, in paediatric patients with tracheobronchial foreign bodies undetected by plain chest radiography.

Methods:

Plain chest radiography was initially performed in 40 children with suspected foreign body aspiration. Computed tomography virtual bronchoscopy was performed in the 20 in whom chest radiography appeared normal. Virtual bronchoscopic images were obtained. All patients underwent rigid bronchoscopy performed by an otolaryngologist blinded to the computed tomography virtual bronchoscopy findings, within 24 hours. Virtual bronchoscopic findings were then compared with the results of rigid bronchoscopy.

Results:

In 12 patients, foreign bodies detected by virtual bronchoscopy were confirmed by rigid bronchoscopy. In one case, a mucous plug was perceived as a foreign body on virtual bronchoscopy. In another case, a minute foreign body was missed on virtual bronchoscopy. The following parameters were calculated: sensitivity, 92.3 per cent; specificity, 85.7 per cent; validity, 90 per cent; positive likelihood ratio, 6.45; and negative likelihood ratio, 0.089.

Conclusion:

In the presence of a positive clinical diagnosis and negative chest radiography, computed tomography virtual bronchoscopy must be considered in all cases of tracheobronchial foreign body aspiration, in order to avoid needless rigid bronchoscopy. Computed tomography virtual bronchoscopy is particularly useful in screening cases of occult foreign body aspiration, as it has high sensitivity, specificity and validity.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2010

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References

1 Kosucu, P, Ahmetoglu, A, Koramaz, I, Orhan, F, Ozdemir, O, Dinc, H et al. Low-dose MDCT and virtual bronchoscopy in pediatric patients with foreign body aspiration. AJR Am J Roentgenol 2004;183:1771–7CrossRefGoogle ScholarPubMed
2 Sorantin, E, Geiger, B, Lindbichler, F, Eber, E, Schimpl, G. CT based virtual tracheobronchoscopy in children – comparison with axial CT and multiplanar reconstruction preliminary results. Pediatr Radiol 2002;32:815Google Scholar
3 Bauer, TL, Steiner, KV. Virtual bronchoscopy: clinical applications and limitations. Surg Oncol Clin N Am 2007;16:323–8Google Scholar
4 Svedstrom, E, Puhakka, H, Kero, P. How accurate is chest radiography in the diagnosis of tracheobronchial foreign bodies in children? Pediatr Radiol 1989;19:520–2Google Scholar
5 Sodhi, KS, Saxena, AK, Singh, M, Rao, KLN, Khandelwal, N. CT virtual bronchoscopy: new non invasive tool in pediatric patients with foreign body aspiration. Indian J Paediatr 2008;75:511–13Google Scholar
6 Kocaoglu, M, Bulakbasi, N, Soylu, K, Demirbag, S, Tayfun, C, Somuncu, I. Thin section axial multidetector computed tomography multiplanar reformatted imaging of children with suspected foreign-body aspiration: is virtual bronchoscopy overemphasized? Acta Radiol 2006;47:746–51Google Scholar
7 Summers, RM, Shaw, DJ, Shelhamer, JH. CT virtual bronchoscopy of simulated endobronchial lesions: effect of scanning, reconstruction and display setting and potential pitfalls. AJR Am J Roentgenol 1998;170:947–50Google Scholar
8 Berger, PE, Kuhn, JP, Kuhns, LR. Computed tomography and the occult tracheobronchial foreign body. Radiology 1980;134:133–5Google Scholar
9 Haliloglu, M, Ciftci, AO, Oto, A, Gumus, B, Tanyel, FC, Senocak, ME et al. CT virtual bronchoscopy in the evaluation of children with suspected foreign body aspiration. Eur J Radiol 2003;48:188–92CrossRefGoogle ScholarPubMed
10 Pinto, A, Scaglione, M, Pinto, F, Guidi, G, Pepe, M, Del Prato, B et al. Tracheobronchial aspiration of foreign bodies: current indications for emergency plain chest radiography. Radiol Med 2006;111:497506Google Scholar
11 Adaletli, I, Kurugoglu, S, Ulus, S, Ozer, H, Elicevik, M, Kantarci, F et al. Utilization of low dose multidetector CT and virtual bronchoscopy in children with suspected foreign body aspiration. Pediatr Radiol 2007;37:3340CrossRefGoogle ScholarPubMed
12 Brenner, MJ, Floyd, L, Collins, SL. Role of computed tomography and bronchoscopy in speech prosthesis aspiration. Ann Otol Rhinol Laryngol 2007;116:882–6Google Scholar
13 Cevizci, M, Dokucu, AI, Baskin, D, Karadag, CA, Server, N, Yalcin, M et al. Virtual bronchoscopy as a dynamic modality in the diagnosis and treatment of suspected foreign body aspiration. Eur J Pediatr Surg 2008;18:398401Google Scholar