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Diagnostic utility of MDCT in evaluation of persistent stridor in children: Large airway causes and benefit of additional findings
Author(s) -
Sodhi Kushaljit S.,
Rana Pratyaksha,
Bhatia Anmol,
Saxena Akshay K.,
Mathew Joseph L.,
Winant Abbey J.,
Lee Edward Y.
Publication year - 2021
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.25382
Subject(s) - stridor , medicine , subglottis , airway , glottis , radiology , airway obstruction , larynx , bronchoscopy , surgery
Abstract Objectives To assess the diagnostic utility of MDCT in the evaluation of persistent stridor in children for the underlying large airway causes and benefit of additional findings. Methods All consecutive pediatric patients who underwent MDCT for the evaluation of persistent stridor from December 2018 to February 2020 were included. Two pediatric radiologists independently reviewed MDCT studies for the presence of abnormalities at six large airway levels: (1) nasopharynx, (2) oropharynx, (3) glottis, (4) subglottis, (5) trachea, and (6) mainstem bronchi. In addition, studies were evaluated for the presence of non‐airway abnormalities. Interobserver agreement between two reviewers was evaluated with kappa statistics. Results There were a total of 40 pediatric patients (age range: 1 day–4 years. MDCT detected large airway abnormalities in 20 (50%) out of 40 patients, including 4 (20%) in nasopharynx, 4 (20%) in glottis, 4 (20%) in trachea, 3 (15%) in subglottis, 3 (15%) in mainstem bronchi, and 2 (10%) in oropharynx. Non‐airway abnormalities were seen in 13 (32.5%) children, including 9 (69%) in the lungs, 3 (23%) in the soft tissue, and 1 (8%) in the bone. The remaining 7 (17.5%) studies were normal. There was excellent interobserver agreement seen for detecting large airway and non‐airway abnormalities ( k > 0.90). Conclusion MDCT has high diagnostic utility in diagnosing large airway causes of persistent stridor in children. It can also provide additional information regarding non‐airway abnormalities. Therefore, MDCT has the potential to be utilized as a noninvasive problem‐solving imaging modality in pediatric patients with persistent stridor.