Clinical applications of MDCT, 3-D and virtual bronchoscopy in tracheobronchial pathologies in pediatric patients. Our experience at children hospital & institute of child Multan & Nishtar medical university, Multan-Pakistan.

OBJECTIVE: To investigate the value of Multidetector CT scan, 3-D and virtual bronchoscopy in tracheobronchial pathologies in pediatric patients.

STUDY DESIGN: Descriptive Prospective study.

PLACE AND DURATION OF THE STUDY: Department of Radiology Nishtar Medical College and Children Hospital complex, Multan. From January, 2009 to January, 2014

PATIENTS AND METHODS: Low dose CT neck and chest with pediatric protocol was performed in 50 consecutive children with clinically suspected foreign body aspiration and tracheobronchial pathologies. Plain chest X-ray of each patient was evaluated at the same time. Multiplanar reformatted imaging with 3-D and virtual bronchoscopy was carried out on workstation after Multidetector CT examination.

RESULTS:  out of 50 patients 42 patients were positive for tracheobronchial foreign bodies were identified by chest CT. Three patients were normal with no tracheobronchial pathology.

Two patients having findings of pulmonary agenesis. Two patient having cystic brochiectatic changes and one patient having diagnosis of tracheal bronchus

Right main stem bronchus was the most common location of foreign body (47.6%) and air trapping was the most common associated finding (28.5%).Sixteen of the 45(35.5%) patients had no abnormalities on plain X-Ray. The difference between Multidetector CT and plain X-Ray results was statistically significant (P <0.001).Foreign bodies were removed successfully on the basis of CT findings.

CONCLUSION: Evaluation of foreign body aspiration of the airway in children and clinically suspected tracheobronchial pathologies must be accomplished by Multidetector CT chest. It will be useful both in showing the exact location of a foreign body before bronchoscopy and in ruling out a foreign body in patients with a low level suspicion and normal or non specific findings on chest radiography.

DR.ABDUL SATTAR ANJUM
BSc,MBBS,DCPS,MCPS,FCPS,EDiR,MPH,CHPE
European Board in Radiology
Prof.& Chair Radiology,Nishtar Medical University,Multan-Pakistan
Training Program Director Radiology,Nishtar Hospital & University,Multan-Pakistan.