Objective To explore the value of chest computed tomography (CT) examination in the diagnosis of adult tracheobronchial foreign body.
Methods Retrospective collection of clinical data from patients diagnosed with tracheobronchial foreign bodies through electronic bronchoscopy examination in our hospital between January 2015 and December 2020. Patients were divided into a group with clear history of foreign body inhalation and a group without clear history of foreign body inhalation based on their medical history. Combined with the results of electronic bronchoscopy examination, the detection rate and localization accuracy of chest CT for tracheobronchial foreign bodies were analyzed, and differences in CT values and positive CT diagnosis rates among different types of foreign bodies were compared; Results: Among the 37 patients with tracheobronchial foreign bodies, there were 28 males and 9 females, with a male to female ratio of approximately 3:1, and an average age of (56.24±13.22) years. Nearly half of the patients had underlying neurological diseases (40.54%, 15/37 cases), and foreign body entrapment was mainly in the right bronchi (78.38%, 29/37 cases). Based on the results of electronic bronchoscopy examination, the positive detection rate of preoperative chest CT for tracheobronchial foreign body was 89.19% (33/37), and the localization accuracy was 84.85% (28/33); There was no statistically significant difference in the positive rate of CT diagnosis between the group with clear history of foreign body inhalation (22/25, 88%) and the group without clear history of foreign body inhalation (11/12, 91.67%) (P>0.05). Among the types of foreign bodies, the average CT value of skeletal/teeth was the highest (496.00±228.89), followed by plastics (136.00±141.08), chili peppers (34.67±21.22) and nuts (28.33±20.98) (P<0.05); For skeletal/teeth, plastics, and metals, the CT detection rate can be 100%, while nuts and chili peppers are relatively lower (85.71% and 50%) (P<0.05); In addition, the most common CT accompanying signs in patients with tracheobronchial foreign bodies were obstructive pneumonia(64.86%, 24/37 cases), while the remaining signs were luminal stenosis (21.62%, 8/37 cases), bronchiectasis (13.51%, 5/37 cases), and bronchial wall thickening (5.40%, 2/37 cases);
Conclusion Chest CT can efficiently detect and locate tracheobronchial foreign bodies of adults, the main accompanying sign is obstructive pneumonia, the detection rate may be related to the type of foreign body, note that plant foreign bodies are prone to missed diagnosis.
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