Radiography Versus Computed Tomography in Paediatric Patients after Blunt Thoracic Trauma
K Yalçın-Şafak, A Akça
Hong Kong J Radiol 2018;21:262-5
DOI: 10.12809/hkjr1816873
Objective: To compare radiography with computed tomography (CT) in the detection of blunt thoracic injuries in paediatric patients.
Methods: Paediatric patients who underwent radiography and CT after blunt thoracic trauma between February
2015 and January 2016 were retrospectively reviewed. Images were independently evaluated by two experienced
radiologists and a consensus reached. The spectrum of blunt thoracic injuries was categorised into the lungs,
airways, pleural space, oesophagus, heart, aorta, diaphragm, and chest wall. Considering CT as the gold
standard, the sensitivity, specificity, and positive and negative predictive values of radiography were calculated.
Results: A total of 39 male and nine female patients aged 1 to 18 years were included; 46 of the 48 patients were
clinically stable. CT detected 19 thoracic injuries in 11 patients, whereas radiography detected 15 of the thoracic
injuries in eight of the patients. Considering CT as the gold standard, radiography had 73% sensitivity, 100%
specificity, and 94% accuracy in detecting thoracic blunt injuries.
Conclusion: Most thoracic CT scans in paediatric patients with thoracic blunt trauma were normal. Chest
radiography can reliably detect blunt trauma in paediatric patients when evaluated by experienced radiologists.
Owing to the risk of radiation exposure, thoracic CT should be performed selectively and based on clinical,
laboratory, and chest radiography findings.
Author affiliation(s):
K Yalçın-Şafak, A Akça: Kartal Dr Lütfü Kırdar Research and Training Hospital, Istanbul, Turkey
中文摘要
胸部X光片與電腦斷層掃描在檢測鈍性胸部創傷的兒童患者應用的比較
K Yalçın-Şafak, A Akça
目的：比較胸部X光片與電腦斷層掃描（CT）在檢測鈍性胸部創傷的兒童患者的應用價值。
方法：回顧性分析2015年2月至2016年1月之間接受胸部X光片與CT檢測鈍性胸部創傷的兒童患者。
兩位經驗豐富的放射科醫師對圖像進行獨立評估並達成共識。鈍性胸部創傷的範圍分為肺、氣道、胸膜間、食管、心臟、主動脈、隔膜和胸壁。以CT為黃金標準來計算X光片的靈敏性、特異性及陽性和陰性預測值。
結果：共包括39名男性和9名女性年齡由1至18歲的患者。48例患者中46例臨床穩定。CT在11例患者中檢測到19例胸部創傷；X光片在其中8例患者中檢測到其中15例胸部創傷。以CT為黃金標準，X光片檢測到鈍性胸部創傷的靈敏性為73%、特異性為100%和準確性為94%。
結論：：大多數鈍性胸部創傷兒童患者的胸廓CT均正常。當由經驗豐富的放射科醫師進行評估時，胸部X光片能有效檢測兒童患者的鈍性胸部創傷。由於輻射暴露的風險，胸廓CT應根據臨床、實驗室和胸部X光片檢查結果選擇性地進行。