Abstract：
BACKGROUND: Rigid bronchoscopy remains the gold standard for the diagnosis of foreign body aspiration (FBA) despite high rates of negative bronchoscopies. The use of computed tomography (CT) imaging in the assessment of FBA has recently emerged and could help obviate unnecessary bronchoscopy in these patients. The aim of this study is to assess the diagnostic accuracy of CT in the diagnosis of pediatric FBA.
METHODS: A systematic literature review was conducted to identify studies reporting the use of CT imaging in suspected pediatric FBA. The search included published articles in Ovid MEDLINE, Ovid EMBASE, PubMed MEDLINE and Web of Science. The search strategy included all articles from inception of the database to January 2021. Manuscripts were reviewed and graded for quality using the QUADAS-2 tool. Subgroup analyses based on the use of virtual bronchoscopy (VB) and sedation was conducted. A meta-analysis evaluating the use of VB in the diagnosis of FBA was also conducted.
RESULTS: Sixteen manuscripts met all inclusion criteria. In total, 2056 pediatric patients ranging from 0.3 to 15 years underwent CT for suspected FBA. The sensitivity and specificity of CT were 98.8% and 96.6%, respectively. VB was used in 71.4% (1391/1948) of patients while sedation during CT was required in 70.2% (1263/1800) of patients. Radiation dosing ranged from 0.04 to 2 mSv, 0.99-59.1 mGy-cm and 0.03-16.99 mGy.
CONCLUSIONS: CT can accurately diagnose pediatric FBA and can help decrease the rate of unnecessary bronchoscopies with an acceptable dose of radiation.
METHODS: A systematic literature review was conducted to identify studies reporting the use of CT imaging in suspected pediatric FBA. The search included published articles in Ovid MEDLINE, Ovid EMBASE, PubMed MEDLINE and Web of Science. The search strategy included all articles from inception of the database to January 2021. Manuscripts were reviewed and graded for quality using the QUADAS-2 tool. Subgroup analyses based on the use of virtual bronchoscopy (VB) and sedation was conducted. A meta-analysis evaluating the use of VB in the diagnosis of FBA was also conducted.
RESULTS: Sixteen manuscripts met all inclusion criteria. In total, 2056 pediatric patients ranging from 0.3 to 15 years underwent CT for suspected FBA. The sensitivity and specificity of CT were 98.8% and 96.6%, respectively. VB was used in 71.4% (1391/1948) of patients while sedation during CT was required in 70.2% (1263/1800) of patients. Radiation dosing ranged from 0.04 to 2 mSv, 0.99-59.1 mGy-cm and 0.03-16.99 mGy.
CONCLUSIONS: CT can accurately diagnose pediatric FBA and can help decrease the rate of unnecessary bronchoscopies with an acceptable dose of radiation.
摘要：
背景：尽管支气管镜检查阴性率很高，但刚性支气管镜检查仍然是诊断异物吸入（FBA）的金标准。最近出现了在FBA评估中使用计算机断层扫描（CT）成像，可以帮助避免这些患者不必要的支气管镜检查。这项研究的目的是评估CT在诊断小儿FBA中的诊断准确性。
方法：进行了系统的文献综述，以确定报告在疑似儿科FBA中使用CT成像的研究。搜索包括OvidMEDLINE上发表的文章，OvidEmbase,PubMedMEDLINE和WebofScience。搜索策略包括从数据库开始到2021年1月的所有文章。使用QUADAS-2工具对手稿进行审查和质量分级。基于使用虚拟支气管镜（VB）和镇静进行亚组分析。还进行了评估VB在FBA诊断中的应用的荟萃分析。
结果：16份手稿符合所有纳入标准。总的来说,2056名0.3至15岁的儿科患者因疑似FBA接受了CT检查。CT的敏感性和特异性分别为98.8%和96.6%,分别。71.4％（1391/1948）的患者使用VB，而70.2％（1263/1800）的患者在CT期间需要镇静。辐射剂量范围为0.04至2mSv，0.99-59.1mGy-cm和0.03-16.99mGy。
结论：CT可以准确诊断小儿FBA，并可以在可接受的辐射剂量下帮助减少不必要的支气管镜检查的发生率。
方法：进行了系统的文献综述，以确定报告在疑似儿科FBA中使用CT成像的研究。搜索包括OvidMEDLINE上发表的文章，OvidEmbase,PubMedMEDLINE和WebofScience。搜索策略包括从数据库开始到2021年1月的所有文章。使用QUADAS-2工具对手稿进行审查和质量分级。基于使用虚拟支气管镜（VB）和镇静进行亚组分析。还进行了评估VB在FBA诊断中的应用的荟萃分析。
结果：16份手稿符合所有纳入标准。总的来说,2056名0.3至15岁的儿科患者因疑似FBA接受了CT检查。CT的敏感性和特异性分别为98.8%和96.6%,分别。71.4％（1391/1948）的患者使用VB，而70.2％（1263/1800）的患者在CT期间需要镇静。辐射剂量范围为0.04至2mSv，0.99-59.1mGy-cm和0.03-16.99mGy。
结论：CT可以准确诊断小儿FBA，并可以在可接受的辐射剂量下帮助减少不必要的支气管镜检查的发生率。
