Advantage of Computed Tomography (CT) Virtual Bronchoscopy in the Evaluation of Children with Suspected Foreign Body Airway

Abstract

Background & Objectives: Foreign body aspiration (FBA) into the tracheo bronchial tree is a frequent and serious cause of respiratory distress and visit to the pediatrics emergency, principally in patients under 3 years of age. Most foreign bodies are not radio opaque and approximately one third of the children admitted will show normal chest X-ray. Virtual bronchoscopy is a relatively new and non-invasive procedure that provides a three dimensional view of the internal walls of the tracheobronchial tree through the reconstruction of axial images. The objectives of the study are, 1) to study the diagnostic accuracy and advantage of virtual bronchoscopy over rigid bronchoscopy in the evaluation of children with suspected FBA and to plan for early management as it is a non-invasive technique; 2) to study the clinical spectrum of children attending with suspected FBA. Methods: An observational study of 37 patients of age 12 yrs and below who underwent Virtual Bronchoscopy for suspected foreign body aspiration in the department of pediatrics and Otorhinolaryngology at MGM Hospital, Warangal is carried out for a period of 1.5 years during 2012-2013. Results: The common age of presentation was 1-3 years with male preponderance. History of foreign body was obtained in 64.86% of cases. Normal X-ray was found in 27.02% of cases. In 75.67% FB detected on rigid bronchoscopy was also revealed on virtual bronchoscopy. False positive percentage was 5.40% and false negative was 2.70%. Sensitivity and specificity was 96.5% and 75% respectively. Ground nuts were the commonest foreign bodies aspirated. Conclusion: Virtual bronchoscopy should be considered in cases with suspected foreign body aspiration, when chest X-ray is normal, to avoid needless rigid bronchoscopy. Virtual bronchoscopy is useful in screening cases of occult foreign body as it has sensitivity, specificity, and validity. M. Yogi et al.

Suitability of òhe modality virtual bronchoscopy with aspiration of a foreign body

“…By CT VB they diagnosed and then, to prevent injury to the trachea and the vocal cords, apply FB with a truncated endobronchial tube. According to Yogi et al (29), because most foreign bodies are not X-rays negative, about one-third of children had normal radiographies. They investigated the diagnostic accuracy of VB vs. RB in assessing children with suspected foreign bodies.…”

“…Yajima et al (31) mention VB as a method of non-invasive imaging and a potential technique for detecting a foreign body in the respiratory system, helping to determine the presence and exact location of the foreign body. Yogi et al (29) define VB as a new, relatively noninvasive procedure that provides a 3dimensional view of the inner walls of the tracheobronchial tree by reconstructing axial images. The authors state that VB should be performed after normal results of X-ray in patients with suspected foreign body to avoid unnecessary RB.…”

“…They obtain the same results as when VB is included. Bhat et al (2) (sensitivity 92.3%, specificity, 85.7%, validity 90%, positive probability coefficient 6.45 and negative probability coefficient 0.089), Yogi et al (29) (sensitivity and specificity respectively 96.5 and 75%, false positive 5.40% and false negative 2.70%) etc. In the presence of positive clinical diagnosis and negative chest X-ray, the authors recommend that VB with CT should be considered in all cases of aspiration of a tracheobronchial foreign body to avoid unnecessary RB.…”

Embedded Spectrum Sensor Network Architecture and Transmission Medium Test Based on TCP/IP

“…Gateway nodes forward cluster-head node command. The business protocol specifies the specific contents of the application layer packet data entity part, the data entity store command parameters, or the contents of the returned data; these data are based on the agreement according to a certain format stored in a data entity within the business; when the receiving end receives the packet, it can also regulate the business protocol data entity [10]. This study analyzes the characteristics of a spectrummonitoring WSN by aiming at the actual demand for network operation.…”

Computed Tomography Virtual Bronchoscopy in Patients With Pulmonary Tuberculosis

“…Дергилев Александр Петрович: ФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава России, 630091, г. Новосибирск, Красный пр., 52. E-mail: a.dergilev@mail.ru спинном мозге, определять с помощью спектрографии активность метаболических процессов в тканях [1][2][3]. В течение последних десятилетий возможности мультисрезовой компьютерной томографии значительно расширились, стало возможным проведение компьютерно-томографической виртуальной бронхоскопии (КТВБ) -неинвазивного метода визуализации трахеобронхиальной системы (ТБС) с возможностью оцен-…”