Duyar Mustafa Orhan, Dündar Mehmet Akif, Karadeli Sinem Nisa, Doğan Murat
Department of Pediatrics, Kayseri City Training and Research Hospital, Health Sciences University, Kayseri 38039, Turkey.
Division of Pediatric Intensive Care, Department of Pediatrics, Kayseri City Training and Research Hospital, Health Sciences University, Kayseri 38039, Turkey.
Children (Basel). 2025 Aug 7;12(8):1035. doi: 10.3390/children12081035.
To evaluate the clinical, radiological, and bronchoscopic features of pediatric patients admitted to the pediatric intensive care unit (PICU) with suspected foreign body aspiration (FBA), and to compare the diagnostic performance of chest radiography (CXR) and computed tomography (CT).
We retrospectively analyzed 71 children admitted to the PICU of Kayseri City Training and Research Hospital for suspected tracheobronchial FBA between January 2020 and December 2024. Demographic data, clinical presentations, imaging findings, bronchoscopic results, and outcomes were recorded. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CXR and CT were calculated using bronchoscopy as the reference standard.
The mean age was 2.61 ± 3.59 years, and 66.1% were male. Organic materials were the most commonly aspirated objects, especially in children aged 0-3 years. The right main bronchus was the most frequently affected site. CXR had a sensitivity of 94.9% (95% CI: 83.1-98.6) and a specificity of 71.0% (95% CI: 53.4-83.9), while CT had a sensitivity of 63.2% (95% CI: 41.0-80.9) and a specificity of 100% (95% CI: 87.5-100.0). Bronchoscopy revealed no foreign body in 45.1% of cases. Most patients (94.4%) fully recovered; complications included two deaths, one lobectomy, and one case of hypoxic sequelae.
FBA remains a critical pediatric emergency, particularly in young children. CXR is a highly sensitive and accessible screening tool, while CT offers high specificity but lower sensitivity. Prompt diagnosis and bronchoscopy by experienced teams ensure favorable outcomes.
评估入住儿科重症监护病房（PICU）的疑似异物吸入（FBA）患儿的临床、放射学和支气管镜检查特征，并比较胸部X线摄影（CXR）和计算机断层扫描（CT）的诊断性能。
我们回顾性分析了2020年1月至2024年12月间因疑似气管支气管FBA入住开塞利市培训与研究医院PICU的71例儿童。记录人口统计学数据、临床表现、影像学检查结果、支气管镜检查结果及预后情况。以支气管镜检查作为参考标准，计算CXR和CT的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
平均年龄为2.61±3.59岁，66.1%为男性。有机物质是最常见的吸入物，尤其是在0至3岁的儿童中。右主支气管是最常受累的部位。CXR的敏感性为94.9%（95%CI：83.1-98.6），特异性为71.0%（95%CI：53.4-83.9），而CT的敏感性为63.2%（95%CI：41.0-80.9），特异性为100%（95%CI：87.5-100.0）。支气管镜检查显示45.1%的病例未发现异物。大多数患者（94.4%）完全康复；并发症包括2例死亡、1例肺叶切除术和1例缺氧后遗症。
FBA仍然是一种严重的儿科急症，尤其是在幼儿中。CXR是一种高度敏感且易于获得的筛查工具，而CT具有高特异性但敏感性较低。经验丰富的团队进行及时诊断和支气管镜检查可确保良好的预后。
