Features of the diagnosis of pneumonia in children: а review
https://doi.org/10.22328/2079-5343-2025-16-3-7-16
Abstract
Objective: To identify the main promising methods of radiation diagnosis of pneumonia, including chest X-ray in children based on theoretical research using the e-Library and PubMed databases.
Materials and Methods: The description of the changes in this study is based on the analysis of the examination of children of different ages with a clinical picture of pneumonia, who underwent routine radiography, low-dose CT and ultrasound of the chest organs, and an artificial intelligence algorithm was used to analyze changes in the lung parenchyma as a result of the radiation study.
Results: As a result of the study, it was concluded that a multimodal approach is necessary in the diagnosis of pneumonia in children, the features of the X-ray picture, depending on age characteristics, and the availability and informativeness of routine chest X-ray in children of different ages was confirmed.
Discussion: The officially recognized main method of radiation diagnosis of pneumonia, the method of radiography, has certain limitations in the interpretation of radiological data in children, which requires further research into the optimization of this method. As a promising direction, the possibilities of developing a multimodal approach using low-dose CT, ultrasound of the chest organs to diagnose pneumonia in children, taking into account the age of the child and the use of several diagnostic criteria, are considered.
Conclusion: The search for reliable, reliable and highly sensitive methods for diagnosing pneumonia in children continues to be relevant. The main place is allocated to routine chest X-ray as the most accessible, informative and low-dose method of radiation diagnosis.
About the Authors
M. K. Shapina
Children’s City Polyclinic No. 68
Russian Federation
Russian Federation
Мaiia K. Shapina - Head of the Department, radiologist of the Department of Radiology,
195248, St. Petersburg, ave. Mentors, 20 building 1
N. A. Ilyina
North-Western State Medical University named after I.I. Mechnikov
Russian Federation
Russian Federation
Natalia A. Ilyina - Dr. of Sci. (Med.), Professor of Radiology Department,
195067, Piskarevskii str., 47, St. Petersburg
References
1. Hassen М., Toma А., Tesfay М. et al. Radiologic Diagnosis and Hospitalization among Children with Severe Community Acquired Pneumonia: A Prospective Cohort Study // BioMed Research International. 2019. Р. 2–3. doi: 10.1155/2019/6202405.
2. Karim R., Afridi J.K., Lala G.E. et al. Clinical Findings and Radiological Evaluation of WHO/Defined Severe Pneumonia Among Hospitalized Children // National Library of Medicine. 2023. Р. 4–5. doi: 10.7759/cureus.33804.
3. Becker J., Decker J.A., Römmele Ch. et al. Artificial Intelligence-Based Detection of Pneumonia in Chest Radiographs // National Library of Medicine. 2022. Р. 4–6. doi: 10.3390/diagnostics12061465.
4. Baltazar L.R., Manzanillo M.G., Gaudillo J. et al. Artificial intelligence on COVID-19 pneumonia detection using chest xray images // National Library of Medicine. 2021. Р. 7–10. doi: 10.1371/journal.pone.0257884.
5. Tsiflikas I., Thater G., Ayx I. et al. Low dose pediatric chest computed tomography on a photon counting detector system — initial clinical experience // Pediatric radiology. 2023. Р. 1059–1061. doi: 10.1007/s00247-022-05584-4.
6. Zhaimkul A.S., Urazayeva S.T., Tusupkalieva K.Sh., Begalin T.B., Kumar G.B., Nurmaganbetova G.J. Modern concepts of epidemiology and risk factors for pneumonia in children. Astana medical journals, 2021, Vol. 108, No. 2, рр. 8–18 (In Russ.).
7. Nascimento-Carvalho C.M. Community-acquired pneumonia among children: the latest evidence for an updated management // J. Pediatr. (Rio J). 2020. Vol. 96, Suppl. 1 (Suppl. 1). Р. 29–38. doi: 10.1016/j.jped.2019.08.003.
8. Masarweh K., Gur M., Toukan Y. et al. Factors associated with complicated pneumonia in children // Pediatr. Pulmonol. 2021. Vol. 56, No. 8. Р. 2700–2706. doi: 10.1002/ppul.25468.
9. Pneumonia in children. Basic facts. 11.11.2022 / World Health Organization: official website. URL: https://www.who.int/ru/news-room/fact-sheets/detail/pneumonia (date of request: 06/12/2023) (In Russ.).
10. Padash S., Mohebbian M.R., Adams S.J. et al. Pediatric chest radiograph interpretation: how far has artifcial intelligence come? A systematic literature review // Pediatric Radiology. 2022. Vol. 52. Р. 1568–1580. doi: 10.1007/s00247-022-05368-w.
11. Teselkin E.V., Lavrenova D.S. Pneumonia in infants. Bulletin of Science, 2023, Vol. 2, No. 1 (58), рр. 297–302 (In Russ.).
12. Grief S.N., Loza J.K. Guidelines for the Evaluation and Treatment of Pneumonia // Prim Care. 2018. Vol. 45, No. 3. Р. 485–503. doi: 10.1016/j.pop.2018.04.001.
13. Kazi S., Hernstadt H., Abo Y. N. et al. The utility of chest x-ray and lung ultrasound in the management of infants and children presenting with severe pneumonia in low-and middle-income countries: A pragmatic scoping review // J. Glob. Health. 2022. Vol. 12. 10013. Р. 3–7. doi: 10.7189/jogh.12.10013.
14. Wang J., Xia C., Sharma A. et al. Chest CT findings and differential diagnosis of mycoplasma pneumoniae pneumonia and mycoplasma pneumoniae combined with Streptococcal pneumonia in children // Journal of Healthcare Engineering. 2021. Vol. 8085530. Р. 4–7. doi: 10.1155/2021/8085530.
15. Baranov A.A., Kozlov R.S., Namazova-Baranova L.S. et al. Modern approaches to the management of children with community-acquired pneumonia. Pediatric pharmacology, 2023, Vol. 20, No. 1, рр. 17–41 (In Russ.). doi: 10.15690/pf.v20i1.2534.
16. Hui Guo, Hua Zhang, Fuping Li. Based on the Auxiliary Effect of X-Ray in the Treatment of Severe Pneumonia in Children with Arterial and Venous Blood Gas Journal of Healthcare Engineering. 2022. Р. 7–8. doi: 10.1155/2022/5786630.
17. O’Gradya K.-A.F., Torzillob P.J., Frawleyc К. et al. The radiological diagnosis of pneumonia in children // Springer Link. 2014.
18. De Benedictis F.M., Kerem Е., Chang A.B. et al. Complicated pneumonia in children // Lancet. 2020. Р. 786–798. doi: 10.1016/S0140-6736(20)31550-6.
19. Saelim J., Kritsaneepaiboon S., Charoonratana V., Khantee Р. Radiographic patterns and severity scoring of COVID-19 pneumonia in children: a retrospective study // BMC Medical Imaging. 2023. Р. 199. doi: 10.1186/s12880-023-01154-8.
20. Yeon Jin Cho, Mi Seon Han, Woo Sun Kim et al. Correlation between chest radiographic findings and clinical features in hospitalized children with Mycoplasma pneumoniae // Plos One. 2019. doi: 10.1371/journal.pone.0219463.
21. Nascimento-Carvalho C.M. Community-acquired pneumonia among children: the latest evidence for an updated management // J. Pediatr. (Rio J). 2020. Vol. 96, No. 1. Р. 29–38. doi: 10.1016/j.jped.2019.08.003.
22. Geppe N.A., Malakhov A.B., Dronov I.A. et al. Outpatient Pneumonia in Children: Problems of Diagnostics, Treatment, and Prevention. Doctor.Ru. Pediatrics, 2015, No. 13 (114), рр. 20–27 (In Russ.).
23. Karimdzhanov I.A. Pneumonia in children. Journal Of New Century Innovations, 2023, Vol. 32, No. 1, рр. 62–67 (In Russ.). doi: 10.5281/zenodo.7512069.
24. Rueda Z.V., Aguilar Y., Maya M.A. et al. Etiology and the challenge of diagnostic testing of community-acquired pneumonia in children and adolescents // BMC Pediatr. 2022. Vol. 22, No. 1. Р. 169. doi: 10.1186/s12887-022-03235-z.
25. Gunaratnam L.C., Robinson J.L., Hawkes M.T. Systematic Review and Meta-Analysis of Diagnostic Biomarkers for Pediatric Pneumonia // J. Pediatric. Infect. Dis. Soc. 2021. Vol. 10, No. 9. Р. 891–900. doi: 10.1093/jpids/piab043.
26. Branche A., Neeser O., Mueller B. et al. Procalcitonin to guide antibiotic decision making // Curr. Opin. Infect. Dis. 2019. Vol. 32. Р. 130–135. doi: 10.1097/QCO.0000000000000522.
27. Najgrodzka P., Buda N., Zamojska A. et al. Lung Ultrasonography in the Diagnosis of Pneumonia in Children-A Metaanalysis and a Review of Pediatric Lung Imaging // Ultrasound Q. 2019. Р. 157–163. doi: 10.1097/RUQ.0000000000000411.
28. Hawkes M.T., Kain K.C. Immune and endothelial activation markers and risk stratification of childhood pneumonia in Uganda: A secondary analysis of a prospective cohort study // PLoS Med. 2022. Vol. 19, No. 7. e1004057. Р. 9–10. doi: 10.1371/journal.pmed.1004057.
29. Hopkins A., Doniger S.J. Point-of-Care Ultrasound for the Pediatric Hospitalist’s Practice // Hosp. Pediatr. 2019. Vol. 9. Р. 707–718. doi: 10.1542/hpeds.2018-0118.
30. Ojuawo O., Ojuawo A., Aladesanmi A. et al. Childhood pneumonia diagnostics: a narrative review // Expert Rev. Respir. Med. 2022. Vol. 16, No. 7. Р. 775–785. doi: 10.1080/17476348.2022.2099842.
31. Chuyashenko E.V., Savadovskaya V.D., Ageeva T.S. et al. Ultrasonic examination of the lungs in pneumonia. Bulletin of Siberian Medicine, 2017, Vol. 16, No. 2, рр. 47–59 (In Russ.). doi: 10.20538/1682-0363-2017-2-47-59.
32. Xin H., Hu H.-Y. Is Lung Ultrasound Useful for Diagnosing Pneumonia in Children: A Meta-Analysis and Systematic Review // Ultrasound Q. 2018. Vol. 34, No. 1. Р. 3–10. doi: 10.1097/RUQ.0000000000000330.
33. Sansone F., Attanasi A., di Filippo P. et al. Usefulness of lung ultrasound in paediatric respiratory diseases // Diagnostics. 2021. Р. 4–7. 11. 1783. doi: 10.3390/diagnostics11101783.
34. Elabbas A., Choudhary R., Gullapalli D. et al. Lung ultrasonography beyong the diagnosis of pediatrics in pneumonia // Cureous. 2022. Vol. 14, No. 2. e22460. Р. 2–6. doi: 10.7759/cureus.22460.
35. Orso D., Ban A., Guglielmo N. Lung ultrasound in diagnosing pneumonia in childhood: a systematic review and meta-analysis // J. Ultrasound. 2018. Vol. 21, No. 3. Р. 183–195. doi: 10.1007/s40477-018-0306-5.
36. Iorio G., Capasso M., Prisco S. et al. Lung Ultrasound Findings Undetectable by Chest Radiography in Children with Community-Acquired Pneumonia // Ultrasound Med. Biol. 2018. Vol. 44, No. 8. Р. 1687–1693. doi: 10.1016/j.ultrasmedbio.2018.04.007.
37. Lissaman C., Kanjanauptom P., Ong C. et al. Prospective observational study of point-of-care ultrasound for diagnosing pneumonia // Arch. Dis Child. 2018. Vol. 0. Р. 1–7. doi: 10.1136/archdischild-2017-314496.
38. Guitart C., Rodriges-Fanjul J., Bobillo-Perez S. et al. An algorithm combining procalcitonin and lung ultrasound improves the diagnosis of bacterial pneumonia in critically ill children: The PROLUSP study, a randomized clinical trial // Pediatric Pulmonology. 2021. Vol. 57, No. 3. Р. 711–723. doi: 10.1002/ppul.25790.
39. Salisbury T., Redfern A., Fletcher E.K. et al. Correct diagnosis of childhood pneumonia in public facilities in Tanzania: a randomised comparison of diagnostic methods // BMJ Open. 2021. Vol. 11, No. 5. e042895. Р. 5–10. doi: 10.1136/bmjopen-2020-042895.
40. Bhuiyan M.U., Snelling T., Sikazwe C. et al. Nasopharyngeal density of respiratory viruses in childhood pneumonia in a highly vaccinated setting: findings from a casecontrol study // BMJ Open Respir. Res. 2020. Vol. 7, No. 1. e000593. Р. 5–6. doi: 10.1136/bmjresp-2020-000593.
Review
For citations:
Shapina M.K., Ilyina N.A. Features of the diagnosis of pneumonia in children: а review. Diagnostic radiology and radiotherapy. 2025;16(3):7-16. (In Russ.) https://doi.org/10.22328/2079-5343-2025-16-3-7-16
Views:
4
Email this article 