Purpose: To evaluate the presence of subpleural sparing as an aid in differentiation of contusion from other causes of lung opacification in children.
Materials and methods: In 29 children, the computed tomographic (CT) features of 40 lung contusions were reviewed for the presence of subpleural sparing. Other CT characteristics of lung contusion such as location, shape, and confluence were also evaluated. The presence of subpleural sparing was also evaluated in cases of atelectasis, pulmonary laceration, and a control group of CT scans obtained in 45 patients with bacterial pneumonia and no history of trauma.
Results: Subpleural sparing was seen at CT in 38 (95%) of the lung contusions and none of the cases of atelectasis, laceration, or pneumonia (P = .0001). Lung contusions tended to be posterior (60%), crescentic (50%), or amorphous (45%) and have confluent and nodular components (70%).
Conclusion: The presence of subpleural sparing on CT scans enables accurate identification of lung contusion and differentiation of contusion from other causes of lung opacification in children after trauma.