Computed tomography in children with community-acquired pneumonia

Abstract

Diagnostic imaging plays a significant role in both the diagnosis and treatment of complications of pneumonia in children and chest radiography is the imaging modality of choice. Computed tomography (CT) on the other hand, is not currently a first-line imaging tool for children with suspected uncomplicated community-acquired pneumonia and is largely reserved for when complications of pneumonia are suspected or there is difficulty in differentiating pneumonia from other pathology. This review outlines the situations where CT needs to be considered in children with pneumonia, describes the imaging features of the parenchymal and pleural complications of pneumonia, discusses how CT may have a wider role in developing countries where human immunodeficiency virus (HIV) and tuberculosis are prevalent, makes note of the role of CT scanning for identifying missed foreign body aspiration and, lastly, addresses radiation concerns.

Identify clinical factors related to Mycoplasma pneumoniae pneumonia with hypoxia in children

“…Chest radiography was performed before admission or during hospitalization. If a patient had one of the following conditions, he or she would undergo a CT scan: 1. the clinical manifestations inconsistent with the chest radiograph;2. suspected airway and lung malformations; 3.serious complications associated with pneumonia; 4.routine treatment ineffective, and exclude other diseases such as interstitial lung disease, pulmonary tuberculosis, so on [ 9 , 10 ]. The percent of CT scans in MPP with hypoxia, RMPP and GMPP was 100,84.88, and 17.69% respectively.…”

Identify clinical factors related to Mycoplasma pneumoniae pneumonia with hypoxia in children

“…Regarding the clinical course, the median duration of fever was 12 (9)(10)(11)(12)(13)(14) days in the MPP with hypoxia group, 10 (8-12) days in the RMPP group and 9 (8-10) days in the GMPP group (P < 0. 01).…”

“…Chest radiography was performed before admission or during hospitalization. And patients would have a CT scan if he or she has one of the following situations: 1. the clinical manifestations are inconsistent with the chest radiograph; 2. airway and lung malformations are suspected; 3. there are serious complications associated with pneumonia; 4. patients fail to respond to treatment and need to exclude other diseases such as interstitial lung disease, pulmonary tuberculosis and so on [9,10] . The percent of CT scans in MPP with hypoxia, RMPP and GMPP was 100%,84.88% and 17.69% respectively.…”

Imaging community-acquired pneumonia in children

“…Anaesthesia is considered by many to be a risk to the child and must be weighed against risks of other diagnostic imaging options. The finale of this minisymposium by Andronikou and colleagues [6] re-examines the gold standard for imaging the lungs -CT. Despite its superiority in imaging the lung parenchyma, airways, mediastinum, pleural space and thoracic cage, CT has taken a hit from the poor perceptions about radiation dose to children.…”

“…Doses in this range must be viewed sensibly according to new information on radiation-induced deoxyribonucleic acid (DNA) damage and repair. In this review, we note these improvements in CT dose in addition to highlighting other advantages of CT such as its speed, its accuracy in identifying pneumonia, its suitability for demonstrating the complications of pneumonia and its utility in exposing lymphadenopathy, which is a key factor in the diagnosis of tuberculosis [6]. For CT to be considered a first-line tool in the imaging of suspected community-acquired pneumonia, the reduced radiation doses must be appreciated and publicised by the wider radiologic fraternity in the context of the minor potential future risks, while the significant limitations of conventional chest radiographs for diagnosing pneumonia and its complications should be acknowledged.…”