Diagnostic value of chest CT scan for airway foreign body aspiration in children

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Abstract Objective Many guidelines recommend chest X-rays as a screening tool for children with suspected foreign body aspiration (FBA). This study was conducted to investigate the diagnostic accuracy of chest CT scans in FBA as a tool to reduce the number of unnecessary bronchoscopies. Material and methods In this retrospective cross-sectional study, the data of individuals under 18 years of age with suspected FBA between April 2023 and December 2023 at Akbar Children’s Hospital in Mashhad, Iran were examined. All patients with suspected foreign bodies in the airways who underwent a chest CT scan and subsequent bronchoscopy were included in the study. An experienced pediatric radiologist prepared a report on the chest CT scans, and the patients were divided into groups with positive and negative CT results according to the FBA. The results of the patient’s bronchoscopy were considered the final diagnosis, and if a foreign body was found during bronchoscopy, its type was recorded. Results On the basis of 77 bronchoscopies, foreign body aspiration was diagnosed in 35 children (positive FBA group). In 42 children, the cause of the symptoms and chest CT findings was not FBA (negative FBA group). The sensitivity and specificity of the chest CT scan for the diagnosis of FBA were 97.14% with 95% CI (91.7%, 100%) and 92.86% with 95% CI (87.3%, 98.5%), respectively. Mucopurulent secretions were the most common bronchoscopy finding in children who underwent flexible bronchoscopy. Conclusion Our study confirms the high diagnostic value of chest CT scans in the detection of FBA in children and argues for their potential role in reducing unnecessary bronchoscopies and their associated complications. Key points • The diagnostic value of chest CT scans in the detection of FBA is high. • Mucopurulent secretions were the most common bronchoscopy finding in children undergoing flexible bronchoscopy. • The most common foreign body was a sunflower seed.

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