Radiography Versus Computed Tomography in Paediatric Patients after Blunt Thoracic Trauma

Objective: To compare radiography with computed tomography (CT) in the detection of blunt thoracic injuries in paediatric patients. Methods: Paediatric patients who underwent radiography and CT after blunt thoracic trauma between February 2015 and January 2016 were retrospectively reviewed. Images were independently evaluated by two experienced radiologists and a consensus reached. The spectrum of blunt thoracic injuries was categorised into the lungs, airways, pleural space, oesophagus, heart, aorta, diaphragm, and chest wall. Considering CT as the gold standard, the sensitivity, specificity, and positive and negative predictive values of radiography were calculated. Results: A total of 39 male and nine female patients aged 1 to 18 years were included; 46 of the 48 patients were clinically stable. CT detected 19 thoracic injuries in 11 patients, whereas radiography detected 15 of the thoracic injuries in eight of the patients. Considering CT as the gold standard, radiography had 73% sensitivity, 100% specificity, and 94% accuracy in detecting thoracic blunt injuries. Conclusion: Most thoracic CT scans in paediatric patients with thoracic blunt trauma were normal. Chest radiography can reliably detect blunt trauma in paediatric patients when evaluated by experienced radiologists. Owing to the risk of radiation exposure, thoracic CT should be performed selectively and based on clinical, laboratory, and chest radiography findings.