E-ISSN 2602-3164
EJMI. 2020; 4(4): 459-463 | DOI: 10.14744/ejmi.2020.69780

Comparison between Chest CT and X-ray Under 15 Years Old: Has Technological Progress Lead to Higher Radiation Exposure?

Furkan Erturk Urfali1, Bahattin Ozkul2
1Department of Radiology, Kutahya Evliya Celebi University Faculty of Medicine, Kutahya, Turkey, 2Department of Radiology, Demiroglu Bilim University Faculty of Medicine, Istanbul, Turkey

Objectives: PA chest X-ray is the first choice for evaluation of the lung pathologies in children. The use of computed tomography (CT) has been increasing due to defensive medicine approaches and diagnostic advantages such as multiplanar imaging. The most important situation in childhood imaging is avoiding high radiation exposure, which is the disadvantage of CT. In this study, diagnostic coherence between chest X-ray and CT and the necessity of chest CT were evaluated. Methods: 644 patients under 15 years old who had admitted to emergency room and underwent chest CT between January 2017 and January 2019 were enrolled in this retrospective study. 348 of 644 patients had just chest CT without chest X-ray. All pathologies in chest CT and chest X-ray were examined by two radiologist (F.E.U, B.O). Lung pathologies were classified as radiologically. Statistical Package for the Social Sciences (SPSS, version 21 for windows) was used for the statistical analysis. The coherence between chest X-ray and CT was evaluated with Cohenís kappa test. P<0.05 was considered. Results: Chest CT was performed only in 0.9% of under 15 years old patients who had chest X-ray between January 2017 and January 2019. Normal radiological findings were found in 288 of 348 patients (83%) who had only CT scanning. There were coherence for all radiological findings (atelectasis, consolidation, ground glass opacity, nodular infiltration, pneumothorax, pleural effusion, bone fracture, mass and cavitary lesions) in between two methods. In 8 patients who had both chest CT and X-ray, cavitary lesion was not detected in chest X-ray (Kappa: 0.490, p=0.002). Conclusion: Patients had mostly normal findings when they were examined by just CT before not underwent chest X-ray. There was a coherence between two examinations in all lung pathologies. Radiation exposure significantly decreases when the patients examined firstly with PA chest X-ray. There are problems such as positioning and inspirium sufficiency in chest X-ray in children, but it is usually enough for evaluating lung pathologies, as seen in our study. We think that it is appropriate to perform chest X-ray firstly in stable patients. Further, we think that it is also appropriate to perform chest Ct when clinical findings was not regress or for excluding additional pathologies. Keywords: Chest, coherence, computed tomography, X-ray

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Urfali F, Ozkul B. Comparison between Chest CT and X-ray Under 15 Years Old: Has Technological Progress Lead to Higher Radiation Exposure?. EJMI. 2020; 4(4): 459-463

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