Value of MSCT for diagnosis of tracheobronchial foreign body aspiration in children: 5-year retrospective study.

BACKGROUND: Tracheobronchial foreign body (TFB) aspiration is a significant cause of respiratory problems in children. Timely diagnosis of TFB is important for decreasing the mortality rate and the incidence of complications. Because of advances in radiology, multi-slice spiral computed tomography (MSCT) has become the best technique for diagnosing TFB.

METHODS: We performed a retrospective study over 5 years from July 2008 to June 2013. We collected information on children who were diagnosed with a TFB by bronchoscopy and analyzed age, sex, location, type of foreign body, and various MSCT manifestations.

RESULTS: A total of 382 children were included and 68.6% of them were aged 1 to <2 years old. The majority (95.8%) of aspirated foreign bodies were vegetation items, and nearly half (47.6%) of them were peanut kernels, followed by sunflower seeds (26.2%). A total of 4.7% of TFBs were in the trachea, 51.0% were in the left main bronchus, and 44.2% were in the right main bronchus. Among the TFBs, 359 (95.5%) showed a high-density shadow in the tracheal/bronchial lumen by MSCT, which could directly establish the presence of a foreign body. Emphysema, localized obstruction and pneumonia were more commonly detected in the 7-21d and ≥21d group compared with those in the <7d group (all P<0.01). Bronchiectasis was found in two children who were diagnosed at least 21 days after aspiration.

CONCLUSIONS: MSCT has great sensitivity for TFBs. Timely diagnosis and treatment of TFB is important to prevent long-term sequalae in children.