Thin-section axial multidetector computed tomography and multiplanar reformatted imaging of children with suspected foreign-body aspiration: Is virtual bronchoscopy overemphasized?
OBJECTIVE
To determine the added value of multidetector computed tomography (MDCT)-assisted virtual bronchoscopy (VB) to axial MDCT and multiplanar reformatted (MPR) imaging with respect to conventional bronchoscopy in the evaluation of children with suspected foreign-body aspiration (FBA).


METHODS
Twenty-one consecutive children (14 male, seven female, age 8 months-7 years, mean age 3.5 years) presenting with the suspicion of FBA were examined with 16-slice MDCT using 100-120 kV, 30-50 mA, 1-mm section thickness, 1.2 pitch ratio, and 0.6-1.0-mm reconstruction interval. Before CT examinations, chest radiographies were also obtained in all cases. VB and MPR imaging were carried out after MDCT examinations.


RESULTS
Nine foreign bodies were identified by gold-standard conventional bronchoscopy. VB, thin-section axial MDCT, and MPR images identified eight of nine foreign bodies. CT scans with MPR images and VB did not reveal a chronic foreign body; and, in one patient, endobronchial mucous was diagnosed as the foreign body. The sensitivity, specificity, and accuracy of thin-section axial MDCT and MPR images alone in the diagnosis of FBA were 88.9%, 91.7%, and 90.5%, respectively. Results were the same as those obtained when VB was also included.


CONCLUSIONS
MDCT with VB and axial/MPR images provide equally valuable information in children with suspected foreign-body aspiration and prevent unnecessary conventional bronchoscopic examinations. However, VB increases total examination time and cost, and it does not provide additional information over MPR images in the evaluation of foreign-body aspiration.
Kocaoglu
M
M
Department of Radiology, Gulhane Military Medical School, Etlik, Ankara, Turkey. kocaoglumurat@yahoo.com
Bulakbasi
N
N
Soylu
K
K
Demirbag
S
S
Tayfun
C
C
Somuncu
I
I
D001980:Bronchi; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D013902:Radiography, Thoracic; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed