Scientific Reports (Mar 2025)
Clinical value and radiographic features of low dose CT scans compared to X rays in diagnosing mycoplasma pneumonia in children
Abstract
Abstract The aim of this article is to explore the lung characteristics and diagnostic value of X-ray and low-dose computed tomography (LDCT) in children with mycoplasma pneumoniae pneumonia (MPP). A total of 807 suspected children with MPP admitted to outpatient and inpatient departments from August 2023 to November 2023, were selected and divided into X-ray group (n = 389) and LDCT group (n = 418) according to the examination method. The two groups received chest X-ray examination and LDCT examination, respectively. Using pathogen detection results as the gold standard, we compared the imaging visible symptoms, diagnostic rate, sensitivity, specificity, diagnostic accuracy, and missed diagnosis rate of the two examination methods. In the LDCT, the main manifestations were thickened lung markings, patchy and striped shadows, followed by ground glass-like shadows, interstitial infiltration of the lungs, tree-in-fog sign, bronchial wall thickening, pleural thickening, consolidation/atelectasis, air bronchogram sign, and branching linear opacities (tree-in-bud sign). The main manifestations of X-ray were thickening of lung markings, followed by pulmonary patchy shadows, interstitial infiltration, and consolidation/atelectasis. LDCT scans revealed 359 cases of pediatric MPP, with 337 true positives cases, 22 false negatives cases, 23 false positives cases, and 36 true negatives cases. On the other hand, X-ray examinations identified 308 cases of pediatric MPP, with 266 true positive cases, 42 false negative cases, 35 false positive cases, and 46 true negative cases. The diagnostic rate, sensitivity, specificity and diagnostic accuracy of LDCT scans were 80.62%, 93.87%, 61.02% and 89.23%, which were higher compared to X-ray examinations, with the values of 68.38%, 86.36%, 56.79% and 80.21%. The missed diagnosis rate for LDCT was 6.13%, which was lower than the 13.64% rate for X-ray. LDCT demonstrated higher visibility of diagnostic rate, sensitivity, specificity and diagnostic accuracy compared to X-ray examinations, and the missed diagnosis rate of LDCT was lower than that of X-ray. Additionally, the radiographic features of LDCT were more characteristic, with simpler procedure, greater clinical utility.
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