Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, 71936-13311, Iran.
Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
Gen Thorac Cardiovasc Surg. 2023 Mar;71(3):198-204. doi: 10.1007/s11748-022-01880-w. Epub 2022 Oct 8.
Information regarding computed tomography (CT) scan as a first-line screening tool for diagnosis of foreign body (FB) ingestion is limited to a few studies. This study aimed to discuss the role of low-dose CT scan in diagnosing FB ingestion and its complications in adults, along with its diagnostic values compared to X-ray and esophagoscopy.
In this retrospective, cross-sectional study, all hospital records of adult patients diagnosed with foreign body ingestion from March 2014 to February 2019 were reviewed.
Among a total of 114 patients, 41 (36.0%) and 86 patients (85.1%) had positive findings in favor of FB in chest radiographs and CT scans, respectively. Esophagoscopy showed the presence of a foreign body in a total of 95 (83.3%) cases, perforation in 14 cases (12.3%), and laceration in nine cases (7.9%). Also, 12 patients (10.5%) had no findings in their esophagoscopy. The sensitivity, specificity, positive predictive value, and negative predictive value of chest X-ray were 39.2%, 91.7%, 97.6%, and 15.1%, respectively. The sensitivity and specificity of CT were reported to be 96.62% and 100%, respectively. The positive predictive value of the CT method was 100%, and its negative predictive value was 80.0%.
CT scan can be the preliminary tool for the diagnosis of FB ingestion. It can decrease hospital stay and hospital costs by avoiding unnecessary endoscopy. Due to the insufficiency of X-ray, low-dose CT can be used as a first-line diagnostic tool, especially in cases with ingestion of radiolucent FBs.
关于计算机断层扫描（CT）作为诊断异物（FB）摄入的一线筛查工具的信息仅限于少数研究。本研究旨在讨论低剂量 CT 扫描在诊断成人 FB 摄入及其并发症中的作用，并与 X 射线和食管镜检查相比其诊断价值。
在这项回顾性、横断面研究中，回顾了 2014 年 3 月至 2019 年 2 月期间所有被诊断为异物摄入的成年患者的住院记录。
在总共 114 名患者中，胸部 X 线和 CT 扫描分别有 41 名（36.0%）和 86 名（85.1%）患者的检查结果支持存在 FB。食管镜检查共发现 95 例（83.3%）存在异物、14 例（12.3%）穿孔和 9 例（7.9%）撕裂。此外，12 名患者（10.5%）的食管镜检查未见异常。胸部 X 线的敏感性、特异性、阳性预测值和阴性预测值分别为 39.2%、91.7%、97.6%和 15.1%。CT 的敏感性和特异性分别为 96.62%和 100%。CT 方法的阳性预测值为 100%，阴性预测值为 80.0%。
CT 扫描可作为诊断 FB 摄入的初步工具。它可以通过避免不必要的内镜检查来减少住院时间和住院费用。由于 X 射线的不足，低剂量 CT 可以作为一线诊断工具，特别是在摄入不透射线的 FB 时。
