Abstract
Purpose
To investigate computed tomography (CT) features which predict lung resection in children with complicated community-acquired pneumonia.
Methods
A retrospective study of CT findings of patients with complicated pneumonia treated between January 2010 and December 2019. Fisher's exact test and ROC curves were used for statistical analysis.
Results
The study cohort consisted of 84 patients who underwent chest CT for complicated pneumonia. Lung resection was performed in 36 patients, 3 patients were treated by lung decortication, 45 patients were cured conservatively. Seven CT features were found statistically significant among the patients who underwent lung resection. 80.5% of patients from the resection group had two or more of these features on the initial CT scan, 64% had three or more. According to ROC analysis, simultaneous occurrence of multiple cavities equal to or greater than 3 cm and lung abscess predicted a pulmonary resection.
Conclusion
The combination of CT features which clearly predict lung resection are the simultaneous occurrence of multiple cavities ≥ 3 cm and lung abscess. The most common triple combination of CT signs in the resected group of patients were multiple cavities ≥ 3 cm, consolidation of lung tissue and pleural effusion < 3 cm.
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References
de Benedictis FM, Kerem E, Chang AB, Colin AA, Zar HJ, Bush A (2020) Complicated pneumonia in children. Lancet 396(10253):786–798. https://doi.org/10.1016/S0140-6736(20)31550-6
Bolaños-Morales FV, Gómez-Portugal EP, Aguilar-Mena ME, Santillán-Doherty PJ, Sotres-Vega A, Santibáñez-Salgado JA (2018) Lung necrosectomy in pediatric patients with necrotizing pneumonia. Gen Thorac Cardiovasc Surg 66(3):155–160. https://doi.org/10.1007/s11748-017-0862-1 (Epub 2017)
Frybova B, Koucky V, Pohunek P, Cejnarova K, Coufal S, Kokesova A, Dotlacil V, Petrasova N, Pos L, Snajdauf J, Hlava S, Polivka N, Rygl M (2021) Lung resection in children with necrotizing pneumonia: outcome and follow-up. Eur J Pediatr Surg. https://doi.org/10.1055/s-0041-1725188 (Epub ahead of print)
Lai JY, Yang W, Ming YC (2017) Surgical management of complicated necrotizing pneumonia in children. Pediatr Neonatol 58(4):321–327. https://doi.org/10.1016/j.pedneo.2016.06.002 (Epub 2016 Oct 28)
Andronikou S, Goussard P, Sorantin E (2017) Computed tomography in children with community-acquired pneumonia. Pediatr Radiol 47(11):1431–1440. https://doi.org/10.1007/s00247-017-3891-0 (Epub 2017 Sep 21)
Tan Kendrick AP, Ling H, Subramaniam R, Joseph VT (2002) The value of early CT in complicated childhood pneumonia. Pediatr Radiol 32(1):16–21. https://doi.org/10.1007/s00247-001-0583-5 (Epub 2001 Nov 15)
Hodina M, Hanquinet S, Cotting J et al (2002) Imaging of cavitary necrosis in complicated childhood pneumonia. Eur Radiol 12:391–396. https://doi.org/10.1007/s003300101008
Masters IB, Isles AF, Grimwood K (2017) Necrotizing pneumonia: an emerging problem in children? Pneumonia (Nathan) 25(9):11. https://doi.org/10.1186/s41479-017-0035-0
Jaffe A, Calder AD, Owens CM, Stanojevic S, Sonnappa S (2008) Role of routine computed tomography in paediatric pleural empyema. Thorax 63(10):897–902. https://doi.org/10.1136/thx.2007.094250 (Epub 2008 May 20)
Wong K, Chiu C, Yeow K et al (2000) Necrotising pneumonitis in children. Eur J Pediatr 159:684–688. https://doi.org/10.1007/PL00008407
Lai SH, Wong KS, Liao SL (2015) Value of lung ultrasonography in the diagnosis and outcome prediction of pediatric community-acquired pneumonia with necrotizing change. PLoS ONE 10:e0130082. https://doi.org/10.1371/journal.pone.0130082
Donnelly LF, Klosterman LA (1998) The yield of CT of children who have complicated pneumonia and noncontributory chest radiography. AJR Am J Roentgenol 170:1627–1631. https://doi.org/10.2214/ajr.170.6.9609186
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Kucerova, B., Kovacova, A.S., Polivka, N. et al. CT findings predicting lung resection in children with complicated community-acquired pneumonia. Pediatr Surg Int 38, 431–436 (2022). https://doi.org/10.1007/s00383-022-05071-9
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DOI: https://doi.org/10.1007/s00383-022-05071-9