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

Jung, Soo Yeon; Pae, So Young; Chung, Sung Min; Kim, Hansu

doi:10.1007/s00405-011-1567-1

Cited by 30 publications

(27 citation statements)

References 12 publications

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“…Although VB has been advocated to be useful in the detection of tracheobronchial anomalies, data on its diagnostic accuracy thus far is limited to the detection of fixed airway stenosis in adults [10][11][12] and foreign body aspiration in children. [20][21][22][23][24][25][26][27] There has been limited data on its accuracy in the detection of dynamic airway abnormalities such as tracheobronchomalacia in both adults and pediatrics. What is currently known is summarized in Table 3.…”

Section: Discussionmentioning

confidence: 99%

A comparison of virtual bronchoscopy versus flexible bronchoscopy in the diagnosis of tracheobronchomalacia in children

Su¹,

Buntain²,

Frawley³

et al. 2016

Pediatric Pulmonology

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Section: Discussionmentioning

confidence: 99%

A comparison of virtual bronchoscopy versus flexible bronchoscopy in the diagnosis of tracheobronchomalacia in children

Su¹,

Buntain²,

Frawley³

et al. 2016

Pediatric Pulmonology

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“…A CTVB is another non-invasive, safe and sensitive diagnostic modality for a bronchial FB 13 14. In current practice, when a chronic bronchial FB is suspected, performing both, HRCT of the chest and CTVB, prior to rigid bronchoscopy, is recommended practice 12–14.…”

Section: Discussionmentioning

confidence: 99%

Muddy clinical waters: a missed betel nut in the bronchus

2015

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A toddler presented with a 5-month history of recurrent episodes of cough, wheezing and fever. Before referral, the toddler had been initially diagnosed as having bronchial asthma and later as having pulmonary tuberculosis. On examination, the patient was febrile and had severe respiratory distress. Chest radiograph and high-resolution CT of the chest revealed collapse of the entire left lung with diffuse bronchiectasis along with a grossly hyperinflated right lung. CT virtual bronchoscopy did not reveal any foreign body. The parents denied any history suggestive of foreign body aspiration and refused consent for rigid bronchoscopy. Nine days after admission, chest physiotherapy was inadvertently prescribed to the patient. Within an hour, the patient experienced acute respiratory deterioration and died. Autopsy revealed a piece of betel nut in the right main bronchus; it had got dislodged from its initial site in the left main bronchus following the chest physiotherapy session.

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“…

We read with great interest the well-written manuscript by Jung et al [1], which reported their experience with multislice computed tomography (MSCT) and virtual bronchoscopic (VB) reconstruction for the diagnosis of bronchial foreign bodies (BFBs) in pediatric patients. They discussed the importance of an early diagnosis, as any delay may cause serious complications.

…”

mentioning

confidence: 98%

Congenital lobar emphysema: the role of multislice computed tomography with virtual bronchoscopy in the differential diagnosis with bronchial foreign bodies

Hochhegger

Irion

Andrade

et al. 2012

Eur Arch Otorhinolaryngol

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We read with great interest the well-written manuscript by Jung et al. [1], which reported their experience with multislice computed tomography (MSCT) and virtual bronchoscopic (VB) reconstruction for the diagnosis of bronchial foreign bodies (BFBs) in pediatric patients. They discussed the importance of an early diagnosis, as any delay may cause serious complications. Most (90 %) of their cases presented with hyperinsuXation of the aVected lung, but only 40 % had witnesses to the aspiration event. Furthermore, about 90 % of BFBs are radiolucent and clinical examination Wndings are generally nonspeciWc. We would like to report our experience with a case of congenital lobar emphysema (CLE), a congenital disease that can simulate BFBs clinically and radiologically. The patient was diagnosed using MSCT and VB.A 5-month-old male was referred to our pediatric emergency ward due to respiratory diYculty. Examination conWrmed that the infant was experiencing mild respiratory diYculty; the respiration rate was 80 breaths/min, the heart rate was 130 beats/min, the facies were normal, weight was 6.0 kg, and length was 75 cm. Cyanosis, jaundice, and signs of heart failure were absent. An examination of the respiratory system revealed reduced movement, decreased vocal resonance, and diminished breath sound on auscultation of the left upper chest. Other systems appeared normal. A chest X-ray showed overdistension of the left-upper lobe, with a mediastinal shift to the right. A CT scan showed hyperlucent segments of the left-upper lobe (attenuated but intact pattern of organized vascularity) with no substantial midline herniation (Fig. 1a, b). Three-dimensional volume rendering (Fig. 1c) showed a high degree of stenosis in the apicoposterior segment. VB (Fig. 1d) conWrmed the highgrade stenosis and excluded other bronchial abnormalities. The postoperative pathological diagnosis conWrmed this initial diagnosis.Congenital lobar emphysema, also referred to as congenital pulmonary overinXation, most commonly aVects a single lobe of the lung, although multiple lobes or speciWc lobar segments may be involved. The disease is characterized by progressive lobar overexpansion, usually with compression of the remaining (ipsilateral) lung. The underlying cause can be a deWcient bronchial cartilage, endobronchial lesions, or extrinsic airway compression (e.g., by a large pulmonary artery or bronchogenic cyst), resulting in airway luminal narrowing and obstruction with air trapping. Although the alveoli expand, the alveolar walls remain intact; therefore, the term emphysema is technically inaccurate [2,3].In conclusion, CLE should be included in the diVerential diagnosis of BFBs, because both may present with pulmonary hyperinsuXation Wndings and nonspeciWc clinical features. Multislice CT with reconstructions of the

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

Cited by 30 publications

References 12 publications

A comparison of virtual bronchoscopy versus flexible bronchoscopy in the diagnosis of tracheobronchomalacia in children

A comparison of virtual bronchoscopy versus flexible bronchoscopy in the diagnosis of tracheobronchomalacia in children

Muddy clinical waters: a missed betel nut in the bronchus

Congenital lobar emphysema: the role of multislice computed tomography with virtual bronchoscopy in the differential diagnosis with bronchial foreign bodies

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