Spiral CT scanning technique in the detection of aspiration of LEGO foreign bodies

Applegate, Kimberly E.; Dardinger, Jeff T.; Lieber, Michael L.; Herts, Brian R.; Davros, William J.; Obuchowski, Nancy A.; Maneker, Amy J

doi:10.1007/s002470100001

Cited by 53 publications

(30 citation statements)

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“…Even nonradio-opaque material, such as plastic LEGO pieces, have been detected in cadavers [15]. Compared to the diagnosis based on symptoms and the chest X-ray, the 3D-CTVB can increase the sensitivity (100%) and speciWcity (81-100%) of the diagnosis [8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional CT with virtual bronchoscopy: a useful modality for bronchial foreign bodies in pediatric patients

Jung

Pae

Chung

et al. 2011

Eur Arch Otorhinolaryngol

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Bronchial foreign bodies (FB) in children are difficult to diagnose when there is no witness to the aspiration event. The experience with three-dimensional CT and virtual bronchoscopic reconstruction (3D-CTVB) was reviewed for the diagnosis of bronchial FB in pediatric patients in this study. A retrospective review of ten pediatric patients (M:F = 5:5) who underwent rigid bronchoscopy by one otolaryngologist for the impression of a bronchial FB, at a tertiary training hospital, from February 2006 to September 2010 is reported. All patients had a plain chest X-ray and 3D-CTVB. The physical, radiological and bronchoscopic findings of the patients were analyzed. The mean duration from the aspiration event to hospital evaluation was 7 days (0-21 days). Four patients (44%) had witnesses to the aspiration event. Hyperaeration of the affected lung was noted in nine patients (90%) on the plain chest X-ray. In all of the patients, the foreign body location, suspected on the preoperative 3D-CTVB, was consistent with the intra-operative bronchoscopic findings. All FBs were successfully removed by rigid bronchoscopy without any complications. In conclusion, the 3D-CTVB was a very safe and useful diagnostic modality for bronchial FBs. The findings of this study suggest that the 3D-CTVB should be considered for the diagnosis of all patients with suspected bronchial FBs.

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Section: Discussionmentioning

confidence: 99%

Three-dimensional CT with virtual bronchoscopy: a useful modality for bronchial foreign bodies in pediatric patients

Jung

Pae

Chung

et al. 2011

Eur Arch Otorhinolaryngol

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“…Early on, it was shown that radiolucent foreign bodies could be found by CT scan in children [15]. A study in a cadaver model using low-dose spiral CT scan reported a combined sensitivity of 89% and combined specificity of 89%, although peanuts, in particular, were not well visualized [8]. Recently, the resolution of the threedimensional chest CT scan has increased, and a threedimensional surface-rendered image can now also clearly delineate airway defects formed by FBA.…”

Section: Discussionmentioning

confidence: 95%

“…Wheezing in the absence of known pulmonary disease, especially if unilateral, should be considered to be due to FBA until proven otherwise [8].…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional computed tomography for detection of tracheobronchial foreign body aspiration in children

et al. 2007

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Foreign body aspiration (FBA) into the tracheobronchial tree is a frequent and serious cause of respiratory problems in children. Chest X-ray (CXR) is often inaccurate in diagnosing FBA when the object is radiolucent. Three-dimensional computed tomography (CT) is a noninvasive technique that can detect the narrowing of the airway resulting from the presence of a foreign body. We conducted a retrospective study comparing the performance of CT scan and CXR in the diagnosis of FBA. Eleven patients (mean age 2.1 years) with a history suggestive of foreign body aspiration were examined by three-dimensional chest CT and CXR during the study. The presence of foreign bodies was confirmed and they were removed by rigid or flexible bronchoscopy under general anesthesia. Foreign body aspiration (FBA) was detected in all the 11 patients by CT scan (sensitivity, 100%), but CXR of three of the patients showed no evidence of FBA (sensitivity, 72.7%). The foreign bodies were located in the right main bronchus (n = 4), the left main bronchus (n = 5), and the trachea (n = 2). The mean length of hospital stay was 3.8 days. In our study, three-dimensional chest CT scan was more sensitive than CXR in detecting the presence of aspirated foreign bodies in children. The superior sensitivity and short time required for CT should help to reduce delays in diagnosis. These benefits may prompt further studies to determine whether CT could be used to reduce the number of unnecessary bronchoscopies performed in children being evaluated for FBA.

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“…Of these, coins are the most common (Reilly and Walter 1992), followed by plastic toy pieces and sharp objects such as pencils and pull-tabs from aluminum cans (Rogers and Igini 1975;Burrington 1976;Blazer et al 1980;Strickland et al 1987;Applegate et al 2001). Inert foreign bodies have little effect on the bronchial mucosa and, unless they cause an obstruction by virtue of their size, can remain undiagnosed for long periods of time (Adegboye et al 2003).…”

Section: Etiology/types Of Foreign Bodiesmentioning

confidence: 97%

“…CT is also an efficient tool for the demonstration of small plastic toy particles such as LEGO pieces (Applegate et al 2001) or rubber products. The presence and location of an intraluminal lesion can easily be detected and multiple intrabronchial findings can at times be identified (Figs.…”

mentioning

confidence: 99%

Foreign Body Aspiration: Imaging Aspects

Koplewitz¹,

Bar‐Ziv²

2014

Pediatric Chest Imaging

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Spiral CT scanning technique in the detection of aspiration of LEGO foreign bodies

Abstract: Rapid, low-dose spiral CT may be used to visualize LEGO FBs in the airway or esophagus. Peanuts were not well visualized.

Cited by 53 publications

References 0 publications

Three-dimensional CT with virtual bronchoscopy: a useful modality for bronchial foreign bodies in pediatric patients

Three-dimensional CT with virtual bronchoscopy: a useful modality for bronchial foreign bodies in pediatric patients

Three-dimensional computed tomography for detection of tracheobronchial foreign body aspiration in children

Foreign Body Aspiration: Imaging Aspects

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