Manach Yves, Pierrot Sébastien, Couloigner Vincent, Ayari-Khalfallah Sonia, Nicollas Richard, Venail Fredéric, Pondaven Soizick, Baculard Florence, Tantcheu Victor
APHP, Necker-Enfants Malades Hospital, Paediatric ENT Department, 75015 Paris, France.
Int J Pediatr Otorhinolaryngol. 2013 May;77(5):808-12. doi: 10.1016/j.ijporl.2013.02.016. Epub 2013 Mar 13.
To evaluate the sensitivity of multidetector computed tomography for confirming suspected foreign body aspiration into the airways in children.
We conducted a multicentre prospective study of 303 children evaluated using multidetector computed tomography with axial analysis complemented by multiplanar reconstruction when required. The images were read by a radiologist before endoscopy then reviewed later by a senior radiologist blinded to the endoscopy findings. Endoscopy was performed routinely.
Foreign bodies were found by endoscopy in 70 of the 303 children. The initial multidetector computed tomography reading was 94% sensitive and 95% specific. For the review, the images for 91 patients were excluded because of motion blurring or absence of larynx visualisation; in the remaining 212 patients, sensitivity was 98% and specificity 97%.
Multidetector computed tomography as performed in our patients cannot replace endoscopy, which remains the reference standard. Nevertheless, multidetector computed tomography is sufficiently sensitive to be of value when foreign body aspiration is not considered initially or when endoscopy is likely to prove challenging.
评估多排螺旋计算机断层扫描（MDCT）对确诊儿童气道内疑似异物吸入的敏感性。
我们对303名儿童进行了一项多中心前瞻性研究，采用多排螺旋计算机断层扫描进行评估，必要时进行轴向分析并辅以多平面重建。图像由一名放射科医生在内镜检查前阅读，随后由一名对内镜检查结果不知情的资深放射科医生进行复查。常规进行内镜检查。
303名儿童中，70名经内镜检查发现有异物。MDCT的初始读数敏感性为94%，特异性为95%。复查时，91名患者的图像因运动模糊或未显示喉部而被排除；在其余212名患者中，敏感性为98%，特异性为97%。
我们患者所接受的MDCT不能替代内镜检查，内镜检查仍是参考标准。然而，当最初未考虑异物吸入或内镜检查可能具有挑战性时，MDCT的敏感性足以提供有价值的信息。
