8th Baltic Congress of Radiology

Pediatric Radiology

oral abstract

Aim: To evaluate diagnostic possibilities of roentgenography, computed tomography (CT) and magnetic resonance imaging (MRI) to diagnose various infectious - inflammatory lower respiratory tract diseases and their complications in children and young adults. Objectives: 1. To determine the incidence and localization of pathologic findings in chest roentgenograms of patients with lower respiratory tract infectious – inflammatory diseases or their complications. 2. To determine the size, incidence and localization of pathologic findings in chest CT of patients with lower respiratory tract infectious – inflammatory diseases or their complications. 3. To determine the size, incidence and localization of pathologic findings in chest MRI of patients with lower respiratory tract infectious – inflammatory diseases or their complications. 4. To compare pathologic findings in chest roentgenograms, CT and MRI studies.

Profiles of radiologic tests and medical documentation of 27 patients, who underwent chest MRI in LUHS Hospital Kauno Klinikos Radiology department in 2017 – 2020, as well as chest roentgenograms and chest CT studies in LUHS Hospital Kauno Klinikos or other medical institutions, were retrospectively analyzed. All patients underwent chest MRI in 7 days period after performing chest CT. Chest MRI images were obtained without patient sedation, using a 1,5T MRI Siemens Magnetom Aera scanner with a body coil; scanning protocol included T2/HASTE, T2/BLADE, TRUFI, T1/VIBE sequences without contrast medium. The incidence, localization, and size of lung parenchymal lesions and mediastinal lymph nodes were evaluated. In addition, there were found and evaluated pleural and chest wall as well as airway pathologic changes and their localization. CT findings were considered to be a standard of reference. Statistical analysis was performed using MS Office Excel 2016 and IBM SPSS Statistics 23.0 programs.

There were 14 males and 13 females enrolled in this study, with a mean age of 11,41 ± 1,009 years (range 5 - 28 years). Mycobacterial tuberculosis was suspected in eighteen patients, three patients had cystic fibrosis with a secondary lung infection, and six patients were examined because of long-term infectious or inflammatory lung disease of unknown origin. In chest CT, pathologic changes were found in all patients, however, 33,3% of chest x-rays and 3,7% of MRIs showed no pathologic lesions. In chest x-rays the most common finding was lung consolidation, the rarest – lung nodules, in chest CT and MRI the most frequent findings were lung nodules and the rarest were bronchiectases and cavitary lesions. The lesions were usually localized in lower lung lobes or distributed diffusely. In roentgenograms and MRI studies, there was a moderate relation of lesions localization to the disease, however, there was no significant relation found in chest CT studies.

Chest x-ray showed low sensitivity and specificity in diagnosing infectious – inflammatory lung diseases. Chest MRI demonstrated high sensitivity and specificity for detecting pleural lesions and bronchiectases, satisfactory – for mediastinal lymph nodes, lung cavitary lesions and lesions of small airways. However, sensitivity and specificity for diagnosing lung nodules, consolidation and ground-glass opacities were low. Nevertheless, MRI sensitivity and specificity were significantly higher for diagnosing lung nodules above 3 mm in diameter.

The aim of this study was to evaluate diagnostic possibilities of X-ray, CT and MRI to diagnose various infectious - inflammatory lower respiratory tract diseases and their complications in children and young adults. Profiles of radiologic tests and medical documentation of 27 patients were retrospectively analyzed. The incidence, localization and size of lung parenchymal lesions and mediastinal lymph nodes, pleural and chest wall and airway pathologic changes were evaluated and compared.

1262