ABSTRACT

Chest radiography is usually sufficient for the diagnosis of lung diseases in pediatric intensive care unit. However, if there is doubt about the diagnosis, thoracic computed tomography can be performed. In this study, we aimed to determine if chest computed tomography provides more information to diagnosis and treatment plan in comparison with chest radiography and discussed the necessity of thoracic computed tomography.

We evaluated records of all patients who underwent chest computed tomography between 01 January 2013 and 01 January 2015 using the hospital data processing system. Mc Nemar’s test was used to investigate the presence of difference in diagnosis between computed tomography and chest X-ray. The concordance between the two imaging methods was displayed using Kappa statistics. SPSS 22.0 software was used for statistical analysis and a p value of less than 0.05 was considered statistically significant.

A total of 54 patients were included in the study. There was no difference between chest computed tomography and chest radiograph in predicting diagnosis (p=0.518). There was a high degree of concordance between the two methods (Kappa: 0.632) (p<0.001). Computed tomography provided no additional information or guidance for changing the treatment of thorax pathology in 57% of patients. The diagnosis could be established with clinical findings and chest X-ray in 74% of patients.

In many patients, chest X-ray was sufficient for correct diagnosis and appropriate treatment plan. In addition, a statistically high degree of correlation was found between the two methods. For this reason, thoracic computed tomography is the diagnostic approach which should be chosen meticulously considering its side effects especially in childhood. However, importance of thoracic computed tomography is not negligible either in cases unresponsive to treatment or when the diagnosis is uncertain.

Keywords: Computed thorax tomography, chest radiography, pediatric intensive care, pulmonary pathology, indication