June 12, 2007 

 

Children's airway is a serious threat to children's health 

 

The emergency of the airway obstruction in children is one of the common acute diseases of children, which seriously threatens the health of children. If handled in an untimely manner can cause serious complications, even death. Pediatric airway foreign body disease among children under the age of 3, most of the foreign bodies were negative foreign body, X-ray negative foreign body that will be X-ray penetration of foreign body, such as melon seeds, peanuts, because the density is small, so it is difficult to directly in the X-ray image enhancement, diagnosis difficult. Negative foreign body in addition to the minority can be directly development, most want to through to the lung field transparency, mediastinum, and diaphragmatic movement and position change, heart shadow inspiratory sex increase indirect signs such as diagnosis. There are three types of pediatric airways, including x-rays, CT and bronchoscopy. The first choice is X-ray, because CT scans are too large for young children, and bronchoscopy is minimally invasive. 

 

 

 

The clinical limitations of static thoracic films and normal X-ray fluoroscopy in children's fluoroscopy X rays were examined 

 

Studies show that children of tracheal and bronchial foreign body X-ray misdiagnosed the missed diagnosis of up to 44.4%, and not of deeds chest X-ray and the lack of good deep breathe, breathe in chest radiograph is the main causes of misdiagnosis and the misdiagnosis. Children or because of the shortness of breath breathing cycle shortened, or for young crying do not cooperate, physicians are often difficult to absorb ideal deep breathe, breathe in the sternum, has consumed the sternum often there is difficult to determine is the issue of inspiratory and expiratory phase. So, static radiography in the diagnosis of pediatric airway foreign body in check one-time success rate low, image quality is difficult to guarantee, and the limitations of microscopic image is not easy to observe. If use normal X-ray fluoroscopy, common perspective image cannot record and repeat, diagnostic radiology doctors often for a long time still cannot be observed after continuous perspective all valuable diagnostic signs, the situation is more common in the low qualification physicians. Repeated and prolonged exposure not only for children with X-ray exposure, but also for delay. 

 

 

 

The dynamic DR is the best choice for the resolution of a child's perspective X-ray 

 

Aiming at these problems, for young children with foreign bodies in history, check the equipment selection dynamic DR, recumbent children to check on the bed, the first perspective with a respiratory cycle, dynamic observation of breathing exercises and mediastinal presence of oscillation (do careful observation can through the video playback). Then select 2 frames per second continuous point pattern, 4 ~ 8 consecutively, and record the dynamic images of the chest of the child's breathing cycle. Because the dot film is quick, for the child who is crying and not cooperating, only the parent has a slight restriction on the double shoulder and the pelvis, and does not affect the effect of the film. By looking at the image of the respiratory cycle, you can find the deep inspirations and the deep exhalation. Finally combining dynamic and static images, observe whether there is a local lung field in the process of breathing abnormal changes of transparency, mediastinum and horizontal movement and position of insulation abnormal changes, indirect signs such as increased heart shadow inspiratory sex to diagnosis. 

 

To sum up, for young children with foreign bodies in history, radiation physicians in the process of cooperate to clinical diagnosis, through dynamic DR continuous point won good deep breathe, breathe in the sternum, coupled with the perspective, basic can clear diagnosis, tracheal and bronchial foreign body. In the case of non-positive findings, the side of the neck should be taken to diagnose the trachea and the substrates under the sound door. Diagnosis when combined with the dynamic and static performance of X line, according to the bronchus and trachea and sequence of subglottic gradually in diagnosis and differential diagnosis, the accuracy of the diagnosis of pediatric airway foreign bodies is greatly increased.