European Archives of Oto-Rhino-Laryngology

, Volume 270, Issue 3, pp 1001–1007

3D images based on MDCT in evaluation of patients with suspected foreign body aspiration

  • Busheng Tong
  • Lichun Zhang
  • Rui Fang
  • Yan Sha
  • Fanglu Chi
Laryngology
  • 195 Downloads

Abstract

To evaluate the value of 3D images based on multi-detect computer tomography (MDCT) for the diagnosis and management of patients with suspected foreign bodies aspiration, and report our experience about diagnosis and management of the aforementioned patients using the 3D images, as well as detail our protocol for the management of those patients. Forty-four patients (37 children, 7 adults) with suspected foreign bodies aspiration who accepted pre-surgical examination and bronchoscopy in our hospital were included in this study. All the patients’ pre-surgical 3D images based on MDCT were reconstructed and analyzed. After that all the results were compared with observations in the surgeries. Among the 37 pediatrics, 34 patients were detected with FB in their tracheobronchial system by the 3D images based on MDCT, and 3 cases were detected negative. The sensitivity of 3D images is 100 %, and the specificity is 75 %.In the adult group, all the 7 cases of FB in the tracheobronchial tree were detected by 3D images and proved by bronchoscopy. 3D images based on MDCT were proved to be a valuable method for the diagnosis of the patients with suspected FB aspiration. In the diagnosis and management of those patients, we considered that both the typical FB aspiration history and the intractable symptoms of cough should be taken as the criteria and the first step for selecting those suspected patients; then 3D images based on MDCT could be taken as the second step and as the selective criteria for those patients who should accept the rigid bronchoscopy.

Keywords

Multi-detect computer tomography Virtual bronchoscopy Virtual rendering Multiplanar reformation Foreign body aspiration Rigid bronchoscopy 

References

  1. 1.
    Johnson DG, Condon VR (1998) Foreign bodies in the pediatric patient. Curr Probl Surg 35(4):271–279PubMedGoogle Scholar
  2. 2.
    Black RE, Johnson DG, Matlak ME (1994) Bronchoscopic removal of aspirated foreign bodies in children. J Pediatr Surg 29(5):682–684PubMedCrossRefGoogle Scholar
  3. 3.
    Metrangelo S, Monetti C, Meneghini L, Zadra N, Giusti F (1999) Eight years’experience with foreign-body aspiration in children: what is really important for a timely diagnosis? J Pediatr Surg 34(8):1229–1231PubMedCrossRefGoogle Scholar
  4. 4.
    Limper AH, Prakash UB (1990) Tracheobronchial foreign bodies in adults. Ann Intern Med 112(8):604–609PubMedGoogle Scholar
  5. 5.
    Zissin R, Shapiro-Feinberg M, Rozenman J, Smorjik J, Apter S, Hertz M (2001) CT findings of the chest in adults with suspected foreign bodies. Eur Radiol 11(4):606–611PubMedCrossRefGoogle Scholar
  6. 6.
    Svedstrom E, Puhakka H, Kero P (1989) How accurate is chestradiography in the diagnosis of tracheobronchial foreign bodies in children? Pediatr Radiol 19(8):520–522PubMedCrossRefGoogle Scholar
  7. 7.
    Haliloglu M, Ciftci AO, Oto A, Gumus B, Tanyel FC, Senocak ME, Buyukpamukcu N, Besim A (2003) CT virtual bronchoscopy in the evaluation of children with suspected foreign body aspiration. Eur J Radiol 48(2):188–192PubMedCrossRefGoogle Scholar
  8. 8.
    Hong SJ, Goo HW, Roh JL (2008) Utility of spiral and cine CT scans in pediatrics suspected of aspirating radiolucent foreign bodies. Otolaryngol Head Neck Surg 138(5):576–580PubMedCrossRefGoogle Scholar
  9. 9.
    Bai WL, Zhou XJ, Gao X, Shao C, Califano JA, Ha PK (2011) Value of chest CT in the diagnosis and management of tracheabronchial foreign bodies. Pediatr Int 53(4):515–518PubMedCrossRefGoogle Scholar
  10. 10.
    Dunn GR, Wardrop P, Lo S, Cowan DL (2002) Management of suspected foreign body aspiration in children. Clin Otolaryngol Allied Sci 27(5):384–386PubMedCrossRefGoogle Scholar
  11. 11.
    Zhijun C, Fugao Z, Niankai Z, Jingjing C (2008) Therapeutic experience from 1,428 patients with pediatric tracheobronchial foreign body. J Pediatr Surg 43(4):718–721PubMedCrossRefGoogle Scholar
  12. 12.
    Li Y, Wu W, Yang X, Li J (2009) Treatment of 38 cases of foreign body aspiration in children causing life-threatening complications. Int J Pediatr Otorhinolaryngol 73(12):1624–1629PubMedCrossRefGoogle Scholar
  13. 13.
    Jung SY, Pae SY, Chung SM, Kim HS (2012) Three-dimensional CT with virtual bronchoscopy: a useful modality for bronchial foreign bodies in pediatric patients. Eur Arch Otorhinolaryngol 269(1):223–228PubMedCrossRefGoogle Scholar
  14. 14.
    Reilly J, Thompson J, MacArthur C, Pransky S, Beste D, Smith M et al (1997) Pediatric aerodigestive foreign body injuries are complications related to timeliness of diagnosis. Laryngoscope 107(1):17–20PubMedCrossRefGoogle Scholar
  15. 15.
    Zerella JT, Dimler M, McGill LC, Pippus KJ (1998) Foreign body aspiration in children: value of radiography and complications of bronchoscopy. J PediatrSurg 33(11):1651–1654Google Scholar
  16. 16.
    Yadav SP, Singh J, Aggarwal N, Goel A (2007) Airway foreign body in children: experience of 132 cases. Singapore Med J 48(9):850–853PubMedGoogle Scholar
  17. 17.
    Adaletli I, Kurugoglu S, Ulus S, Ozer H, Elicevik M, Kantarci F et al (2007) Utilization of low-dose multidetector CT and virtual bronchoscopy in children with suspected foreign body aspiration. PediatrRadiol 37(1):33–40Google Scholar
  18. 18.
    Bhat KV, Hegde JS, Nagalotimath US, Patil GC (2010) Evaluation of computed tomography virtual bronchoscopy in paediatric tracheobronchial foreign body aspiration. J LaryngOlotol 124(8):875–879CrossRefGoogle Scholar
  19. 19.
    Veras TN, Hornburg G, Schner AM, Pinto LA (2009) Use of virtual bronchoscopy in children with suspected foreign body aspiration. J Bras Pneumol 35(9):937–941PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Busheng Tong
    • 1
  • Lichun Zhang
    • 1
  • Rui Fang
    • 1
  • Yan Sha
    • 2
  • Fanglu Chi
    • 1
  1. 1.Department of Otorhinolaryngology-Head and Neck SurgeryEENT hospital of Fudan UniverstiyShanghaiChina
  2. 2.Department of Radiologythe EENT Hospital of Fudan UniversityShanghaiChina

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