Allergy, Asthma & Respiratory Disease

  • 제6권5호
  • /
  • Pages.241-247
  • /
  • 2018
  • /
  • 2288-0402(pISSN)
  • /
  • 2288-0410(eISSN)
대한천식알레르기학회 (The Korean Academy of Asthma, Allergy and Clinical Immunology)
권호 표지
DOI QR코드

DOI QR Code

기도 내 이물질 소아에서 단순 흉부방사선사진과 가슴 전산화단층촬영

Chest radiographs and computed tomography scans in children with airway foreign body

  • 박유미 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김경훈 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이혜진 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이의경 (가야소아청소년과의원) ;
  • 양은애 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김환수 (가톨릭대학교 의과대학 소아과학교실) ;
  • 전윤홍 (가톨릭대학교 의과대학 소아과학교실) ;
  • 윤종서 (가톨릭대학교 의과대학 소아과학교실) ;
  • 임수아 (가톨릭대학교 의과대학 영상의학교실) ;
  • 김현희 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김진택 (가톨릭대학교 의과대학 소아과학교실)
  • Park, Yu Mi (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Kyunghoon (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Lee, Hye Jin (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Lee, Eu Kyoung (Kaya Pediatrics) ;
  • Yang, Eun Ae (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hwan Soo (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Chun, Yoon Hong (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Yoon, Jong-Seo (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Im, Soo Ah (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hyun Hee (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Jin Tack (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 투고 : 2017.12.27
  • 심사 : 2018.06.30
  • 발행 : 2018.09.30
⟨ 이전 논문 다음 논문 ⟩

초록

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.

키워드

참고문헌

  1. Kang SH, Bae KS, Bang KW, Kim HS, Chun YH, Yoon JS, et al. Foreign body aspiration in 48 children: clinical manifestations and outcomes. Allergy Asthma Respir Dis 2016;4:107-13. https://doi.org/10.4168/aard.2016.4.2.107
  2. Boufersaoui A, Smati L, Benhalla KN, Boukari R, Smail S, Anik K, et al. Foreign body aspiration in children: experience from 2624 patients. Int J Pediatr Otorhinolaryngol 2013;77:1683-8. https://doi.org/10.1016/j.ijporl.2013.07.026
  3. Ciftci AO, Bingol-Kologlu M, Senocak ME, Tanyel FC, Buyukpamukcu N. Bronchoscopy for evaluation of foreign body aspiration in children. J Pediatr Surg 2003;38:1170-6. https://doi.org/10.1016/S0022-3468(03)00263-X
  4. Taskinlar H, Bahadir GB, Erdogan C, Yigit D, Avlan D, Nayci A. A diagnostic dilemma for the pediatrician: radiolucent tracheobronchial foreign body. Pediatr Neonatol 2017;58:264-9. https://doi.org/10.1016/j.pedneo.2016.07.003
  5. Gang W, Zhengxia P, Hongbo L, Yonggang L, Jiangtao D, Shengde W, et al. Diagnosis and treatment of tracheobronchial foreign bodies in 1024 children. J Pediatr Surg 2012;47:2004-10. https://doi.org/10.1016/j.jpedsurg.2012.07.036
  6. Singh H, Parakh A. Tracheobronchial foreign body aspiration in children. Clin Pediatr (Phila) 2014;53:415-9. https://doi.org/10.1177/0009922813506259
  7. Shlizerman L, Mazzawi S, Rakover Y, Ashkenazi D. Foreign body aspiration in children: the effects of delayed diagnosis. Am J Otolaryngol 2010; 31:320-4. https://doi.org/10.1016/j.amjoto.2009.03.007
  8. Hammer J. Acquired upper airway obstruction. Paediatr Respir Rev 2004; 5:25-33. https://doi.org/10.1016/j.prrv.2003.09.007
  9. Ayed AK, Jafar AM, Owayed A. Foreign body aspiration in children: diagnosis and treatment. Pediatr Surg Int 2003;19:485-8. https://doi.org/10.1007/s00383-003-0965-x
  10. Hegde SV, Hui PK, Lee EY. Tracheobronchial foreign bodies in children: imaging assessment. Semin Ultrasound CT MR 2015;36:8-20. https://doi.org/10.1053/j.sult.2014.10.001
  11. Song ES, Han DK, Cho HJ, Jeong IS, Yoon N, Ma JS, et al. Radiodensity on serial chest X-rays for the diagnosis of foreign body aspiration in children. Indian Pediatr 2015;52:663-7. https://doi.org/10.1007/s13312-015-0693-z
  12. Heyer CM, Bollmeier ME, Rossler L, Nuesslein TG, Stephan V, Bauer TT, et al. Evaluation of clinical, radiologic, and laboratory prebronchoscopy findings in children with suspected foreign body aspiration. J Pediatr Surg 2006;41:1882-8. https://doi.org/10.1016/j.jpedsurg.2006.06.016
  13. 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;111:497-506. https://doi.org/10.1007/s11547-006-0045-0
  14. Sattar A, Ahmad I, Javed AM, Anjum S. Diagnostic accuracy of chest x-ray in tracheobronchial foreign body aspiration in paediatric patients. J Ayub Med Coll Abbottabad 2011;23:103-5.
  15. Svedstrom E, Puhakka H, Kero P. How accurate is chest radiography in the diagnosis of tracheobronchial foreign bodies in children? Pediatr Radiol 1989;19:520-2. https://doi.org/10.1007/BF02389562
  16. Brown JC, Chapman T, Klein EJ, Chisholm SL, Phillips GS, Osincup D, et al. The utility of adding expiratory or decubitus chest radiographs to the radiographic evaluation of suspected pediatric airway foreign bodies. Ann Emerg Med 2013;61:19-26. https://doi.org/10.1016/j.annemergmed.2012.05.026
  17. Hitter A, Hullo E, Durand C, Righini CA. Diagnostic value of various investigations in children with suspected foreign body aspiration: review. Eur Ann Otorhinolaryngol Head Neck Dis 2011;128:248-52. https://doi.org/10.1016/j.anorl.2010.12.011
  18. Kim IG, Brummitt WM, Humphry A, Siomra SW, Wallace WB. Foreign body in the airway: a review of 202 cases. Laryngoscope 1973;83:347-54. https://doi.org/10.1288/00005537-197303000-00004
  19. Assefa D, Amin N, Stringel G, Dozor AJ. Use of decubitus radiographs in the diagnosis of foreign body aspiration in young children. Pediatr Emerg Care 2007;23:154-7. https://doi.org/10.1097/PEC.0b013e3180328cd8
  20. Tokar B, Ozkan R, Ilhan H. Tracheobronchial foreign bodies in children: importance of accurate history and plain chest radiography in delayed presentation. Clin Radiol 2004;59:609-15. https://doi.org/10.1016/j.crad.2004.01.006
  21. Bai W, Zhou X, Gao X, Shao C, Califano JA, Ha PK. Value of chest CT in the diagnosis and management of tracheobronchial foreign bodies. Pediatr Int 2011;53:515-8. https://doi.org/10.1111/j.1442-200X.2010.03299.x
  22. Hong SJ, Goo HW, Roh JL. Utility of spiral and cine CT scans in pediatric patients suspected of aspirating radiolucent foreign bodies. Otolaryngol Head Neck Surg 2008;138:576-80. https://doi.org/10.1016/j.otohns.2007.12.039
  23. 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;48:188-92. https://doi.org/10.1016/S0720-048X(02)00295-4
  24. Zerella JT, Dimler M, McGill LC, Pippus KJ. Foreign body aspiration in children: value of radiography and complications of bronchoscopy. J Pediatr Surg 1998;33:1651-4. https://doi.org/10.1016/S0022-3468(98)90601-7

피인용 문헌

  1. Foreign Body Aspiration in Egyptian Children Clinical, Radiological and Bronchoscopic Findings vol.14, pp.None, 2021, https://doi.org/10.2147/jmdh.s326967