TITLE:
Pertinence of Children’s Chest X-Ray Request Form and Practice at the Regional Hospital of Ngaoundere Cameroon
AUTHORS:
Mathurin Guena Neossi, Florent Zilbinkai Alapha
KEYWORDS:
Pertinence, Chest X-Ray, Children, Request Form, Practice
JOURNAL NAME:
Open Journal of Radiology,
Vol.8 No.4,
November
8,
2018
ABSTRACT: Background: Chest X-ray is frequently performed for evaluation of chest disease in both adults and children. Children are more exposed to the adverse effects of radiation as compared to adults. During our daily practice, we noticed that most of children’s chest X-ray results were normal. Purpose: This study aimed to evaluate the indications, the technic, the irradiation and the result of chest X-rays in children in order to know if the practice of these X-rays was relevant. Method: Cross-sectional and descriptive study conducted at the Imaging Regional Center of Ngaoundere from April to August 2017. A total number of 145 radiographs and 140 X-ray requests of 140 children were considered in this work. The conformity of the request were verified according to the recommendations of the National Agency for Accreditation and Health Evaluation in France (NAAHE), technical condition of realization and results were appreciated and the entrance surface dose (ESD) of the patients was estimated using a mathematical algorithm. Results: Children under 5 years (63.5%) were more represented in our study. The main indications were: cough (22.1%), suspicion of pneumonia (16.4%) and bronchitis (15.7%). No indication was mentioned on 69.3% of the request forms. After confrontation to the “Guide for proper use of medical imaging examinations” (GPU), we only had 24% conformity of indications. 82.7% of the examinations required immobilization assistance by the parents. Most of the children were imaged in a standing-up position (82.9%) and the anterior-posterior view (77.9%) was more practiced. After the analysis of the pictures, 62% of them presented an optimal contrast, while 42.1% of X-ray were performed without beam collimation. 25 X-rays were repeated: 12 (48%) because of patient’s motion and 13 (52%) of mispositionning. After interpretation, 87 (62.14%) chest X-ray were normal. Main lesion observed were pneumonia (17.14%) followed by bronchopeumopathy (5.71%) and bronchitis (5%). The obtained ESD values were 0.11, 0.15 and 0.17 mGy respectively for the 0 - 1 year, 1 - 5 year and 5 - 10 year age groups; 0.2 and 0.57 respectively for postero-anterior (PA) and lateral (LAT) view for the age group 10 - 15 years, which were slightly greater than the values in internationally published studies. Conclusion: The request for children chest X-ray is not relevant in terms of indication, technical conditions of realization and irradiation.