Radiodensity on Serial Chest X-rays for the Diagnosis of Foreign Body Aspiration in Children.

Objectives: To evaluate the utility of measuring lung radiodensity from chest X-ray for the diagnosis of foreign body aspiration Methods: Records of 59 children with foreign body aspiration were retrospectively reviewed. Lung radiodensity and radiodensity ratio (right/left lung radio density) before and after foreign body removal were measured. Radiodensity was calculated as the relative score compared with the tenth thoracic vertebra body (100 points) and the background (0 point). The change of radiodensity ratio (difference in radiodensity ratio of the second X-ray from that of first X-ray) was compared between 22 patients (foreign body group) and 22 normal subjects (control group). Results: In the group of foreign body in the left bronchus, the mean (SD) radiodensity of the left lung [53.5 (12.8)] was lower than that of the right lung [60.8 (7.7), P<0.01] and it increased after foreign body removal [60.0 (6.9), P=0.02]. The radiodensity ratio decreased from 1.20 (0.30) to 0.96 (0.09) (P<0.01) after foreign body removal. In the group with a foreign body in the right bronchus, the radiodensity of the right lung [51.8 (12.8)] was lower than that of left lung [62.0 (11.7), P=0.03], and it also increased after foreign body removal [58.4 (9.6), P=0.03]. The change of radiodensity ratio in the foreign body group [15.7 (17.8)%] was higher than the control group [5.4 (4.3)%, P=0.01] and the cutoff value was 7.5%. Conclusion: Radiodensity from chest X-ray could be a useful tool for diagnosing foreign body aspiration in children.

Values of Lung CT in Children with a Vague History of Aspiration / 소아과

PURPOSE: The purpose of this study was to investigate the diagnostic value of spiral computed tomography (CT) using contiguous slices with partially thin sections around the hilar level in the bronchial foreign bodies of children with a vague history of aspiration. METHODS: Fourteen children were identified to be examined with spiral CT due to obscure histories of aspiration episodes. A retrospective analysis of the medical records provided information concerning the clinical and radiological findings. RESULTS: Of the 14 patients examined with spiral CT, there were no significant differences among the clinical and initial radiological findings with the exception of gender distribution. However, the spiral CT scans allowed accurate discrimination among patients with a vague history of aspiration episodes, in which seven were identified with bronchial foreign body aspiration and seven with bronchiolitis, asthma, tracheobronchitis and/or pneumonia. CONCLUSION: We found that spiral CT using contiguous slices with partially thin sections around the hilar level are a useful non-invasive method in the early diagnosis of bronchial foreign bodies in children with a vague history of aspiration.