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MDCT in Children: Scan Techniques and Contrast Issues

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Abstract

Computed tomography (CT) is an essential imaging modality in the evaluation of infants and children [1]. Technical advances, especially with multidetector-array CT (MDCT) have provided increased opportunities for established uses as well as for new applications, such as evaluation of possible appendicitis, renal colic, and cardiovascular abnormalities. However, these technical advances are often complex and can be confusing. This complexity arises from the equipment, with increasing numbers of channels or arrays, and from the scan technique, consisting of multiple options for scan settings and intravenous (IV) contrast medium administration. Only with a solid understanding of these technical considerations will diagnostic MDCT in children be optimized. Therefore, this chapter focuses on the technical aspects of MDCT rather than on its applications. In addition to this technical discussion, issues in patient safety related to MDCT are addressed, including radiation management as a fundamental responsibility of the radiologist and radiology personnel [2].

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References

  1. Donnelly LF, Frush DP (2003) Pediatric multidetector body CT. Radiol Clin North Am 41:637–655

    Article  PubMed  Google Scholar 

  2. Frush DP, Frush KS (2006) In a new kind of light: patient safety in pediatric radiology. Clin Ped Emerg Med 7:255–260

    Article  Google Scholar 

  3. Donnelly LF (1997) Commentary: oral contrast medium administration for abdominal CT-reevaluating the benefits and disadvantages in the pediatric patient. Pediatr Radiol 27:770

    Article  CAS  PubMed  Google Scholar 

  4. Kaste S, Laningham F, Stazzone M et al (2007) Safety in pediatric MR and cardiac CT. Pediatr Radiol 37:409–412

    Article  PubMed  Google Scholar 

  5. Frush DP (2005) Multislice CT-Pediatric Principles and Protocols. In: Knollman F, Coakley FV, eds. Elsevier Inc., Philadelphia, PA, 179–201

    Google Scholar 

  6. Cohen MD, Smith JA (1994) Intravenous use of ionic and nonionic contrast agents in children. Radiology 191:793

    CAS  PubMed  Google Scholar 

  7. Dillman JR, Strouse PJ, Ellis JH et al (2007) Incidence and severity of acute allergic-like reactions to i.v. nonionic iodinated contrast material in children. AJR Am J Roentgenol 188(6):1643–1647. Erratum in: AJR Am J Roentgenol 2007 Sep; 189(3):512

    Article  PubMed  Google Scholar 

  8. Gaca AM, Frush DP, Hohenhaus S et al (2007) Enhancing pediatric safety: using simulation to assess radiology resident preparedness for anaphylaxis from intravenous contrast media. Radiology 245:236–44

    Article  PubMed  Google Scholar 

  9. UNSCEAR (2000) Medical radiation exposures, annex D. United Nations Scientific Committee on the Effects of Atomic Radiation Report to the General Assembly; New York

    Google Scholar 

  10. Frush DP, Applegate K (2004) Computed tomography and radiation: Understanding the issues. J Am Coll of Radiol 1:113–119

    Article  Google Scholar 

  11. Brenner DJ, Hall EJ (2007) Computed Tomography — An Increasing Source of Radiation Exposure. NEJM 357:2277–2284

    Article  CAS  PubMed  Google Scholar 

  12. Frush DP, Donnelly LF, Rosen N (2003) CT and radiation risks: What pediatric health care providers should know. Pediatrics 112:951–957

    Article  PubMed  Google Scholar 

  13. Amis ES Jr, Butler PF, Applegate KE et al (2007) American College of Radiology white paper on radiation dose in medicine. J Am Coll Radiol 4:272–84

    Article  PubMed  Google Scholar 

  14. Slovis TL, Frush DP, Berdon WE et al (2007) Biological Effects of Diagnostic Radiation on Children. In: Slovis T (ed) Caffey’s Pediatric Diagnostic Imaging. 11th Edition. Elsevier 3–12

    Google Scholar 

  15. Frush DP (2006) Categorical Course in Physics: Radiation Dose and Image Quality for Pediatric CT: clinical considerations. Radiological Society of North American 167–182

    Google Scholar 

  16. Thomas KE, Wang BB (2008) Age-specific effective doses for Pediatric MSCT examinations at a large children’s hospital using DLP conversion coefficients; a simple estimation method. Pediatr Radiol (In press)

    Google Scholar 

  17. Huda W, Vance A (2007) Patient radiation doses from adult and pediatric CT. AJR Am J Roentgenol 188:540–6

    Article  PubMed  Google Scholar 

  18. Huda W (2008) Computing effective doses to pediatric patients undergoing body CT examinations. Pediatr Radiol (In press)

    Google Scholar 

  19. Cohen RA, Frush DP, Donnelly LF (2000) Data acquisition for pediatric CT angiography: problems and solutions. Pediatr Radiol 30:813–822

    Article  CAS  PubMed  Google Scholar 

  20. Fleischmann D (2003) Use of high-concentration contrast media in multiple-detector-row CT: principles and rationale. Eur Radiol 13 (Suppl 5):M14–20

    PubMed  Google Scholar 

  21. Frush DP, Herlong RJ (2005) Pediatric thoracic CT angiography. Pediatr Radiol 35:11–25

    Article  PubMed  Google Scholar 

  22. Chan FP, Rubin GD (2005) MDCT angiography of pediatric vascular diseases of the abdomen, pelvis, and extremities. Pediatr Radiol 35:40–53

    Article  PubMed  Google Scholar 

  23. Salis AI, Eclavea A, Johnson MS et al (2004) Maximal flow rates possible during power injection through currently available PICCs: an in vitro study. J Vasc Interv Radiol 15:275–281

    PubMed  Google Scholar 

  24. Hollingsworth CL, Frush DP, Cross M et al (2003) Helical CT of the body: A survey of techniques used for pediatric patients. AJR Am J Roentgenol 180:401–406

    PubMed  Google Scholar 

  25. Frush DP, Donnelly LF, Bisset GS (2001) Technical innovation: Effect of scan delay on hepatic enhancement for pediatric abdominal multislice helical CT. AJR Am J Roentgenol 176:1559–1561

    CAS  PubMed  Google Scholar 

  26. Frush DP, Spencer EB, Donnelly LF et al (1999) Optimizing contrast-enhanced abdominal CT in infants and children using bolus tracking. AJR Am J Roentgenol 172:1007

    CAS  PubMed  Google Scholar 

  27. Frush DP (2005) Technique of pediatric thoracic CT angiography. Radiol Clin North Am 43(2):419–433

    Article  PubMed  Google Scholar 

  28. da Costa e Silva EJ, da Silva GA (2007) Eliminating unenhanced CT when evaluating abdominal neoplasms in children. AJR Am J Roentgenol 189:1211–1214

    Article  PubMed  Google Scholar 

  29. van der Molen AJ, Geleijns J (2007) Overranging in multisection CT: quantification and relative contribution to dose-comparison of four 16-section CT scanners. Radiology 242:208–216

    Article  PubMed  Google Scholar 

  30. Donnelly LF, Emery KH, Brody AS et al (2001) Minimizing radiation dose for pediatric body applications of single-detector helical CT: Strategies at a large children’s hospital. AJR Am J Roentgenol 176(2):303–306

    CAS  PubMed  Google Scholar 

  31. Arch ME, Frush DP (2008) Pediatric Body MDCT: A Five-Year Follow-Up Survey of Scan Parameters Used by Pediatric Radiologists. AJR Am J Roentgenol February 2008 (In press)

    Google Scholar 

  32. Vade A, Demos TC, Olson MC et al (1996) Evaluation of image quality using 1∶1 pitch and 1∶51 pitch helical CT in children: a comparative study. Pediatr Radiol 26:891–893

    Article  CAS  PubMed  Google Scholar 

  33. Vade A, Olson MC, Vittore CP et al (1999) Hepatic enhancement analysis in children using Smart Prep monitoring for 2:1 pitch helical scanning. Pediatr Radiol 29:689–693

    Article  CAS  PubMed  Google Scholar 

  34. Long FR, Castile RG, Brody AS et al (1999) Lungs in infants and young children: improved thin-section computed tomography with a noninvasive controlled-ventilation technique: initial experience. Radiology 212:588–593

    CAS  PubMed  Google Scholar 

  35. Siegel MS (2003) Multiplanar and three-dimensional multidetector row CT of thoracic vessels and airways in the pediatric population. Radiology 229:641–650

    Article  PubMed  Google Scholar 

  36. Lucaya J, Piqueras J, García-Peña P et al (2000) Lowdose high-resolution CT of the chest in children and young adults: dose cooperation, artifact incidence, and image quality. AJR Am J Roentgenol 175:985–992

    CAS  PubMed  Google Scholar 

  37. Rogalla P, Stover B, Scheer I et al (1999) Low-dose spiral CT; applicability to paediatric chest imaging. Pediatr Radiol 29:565–569

    Article  CAS  PubMed  Google Scholar 

  38. Ambrosino MM, Genieser NB, Roche KJ et al (1994) Feasibility of high-resolution, low-dose chest CT in evaluating the pediatric chest. Pediatr Radiol 24:6–10

    Article  CAS  PubMed  Google Scholar 

  39. Pacharn P, Poe SA, Donnelly LF (2002) Low-tubecurrent multidetector CT for children with suspected extrinsic airway compression. AJR Am J Roentgenol 179:1523–1527

    PubMed  Google Scholar 

  40. Cohnen M, Fischer H, Hamacher J et al (2000) CT of the head by reduced current and kilovoltage: relationship between image quality and dose reduction. Am J Neuroradiol 21:1654–1660

    CAS  PubMed  Google Scholar 

  41. Hein E, Rogalla P, Klingebiel R et al (2002) Low-dose CT of the paranasal sinuses with eye lens protection: effect on image quality and radiation dose. Eur Radiol 12:1693–1696

    Article  PubMed  Google Scholar 

  42. Mulkens TH, Broers C, Fieuws S (2005) Comparison of effective doses for low-dose MDCT and radiographic examination of sinuses in children. AJR Am J Roentgenol 184:1611–1618

    CAS  PubMed  Google Scholar 

  43. Salamipour H, Jimenez RM, Brec SL et al (2005) Multidetector row CT in pediatric musculoskeletal imaging. Pediatr Radiol 35:555–564

    Article  PubMed  Google Scholar 

  44. Chapman VM, Kalra M, Halpern E et al (2004) 16-MDCT of the posttraumatic pediatric elbow: optimum parameters and associated radiation dose. AJR Am J Roentgenol 185:516–521

    Google Scholar 

  45. Anupindi S, Perumpillichira J, Jaramillo D et al (2005) Low-dose CT colonography in children: initial experience, technical feasibility, and utility. Pediatr Radiol 35:518–524

    Article  PubMed  Google Scholar 

  46. Kalra MK, Maher MM, Toth TL et al (2004) Techniques and applications of automatic tube current modulation for CT. Radiology 233:649–657

    Article  PubMed  Google Scholar 

  47. McCollough CH, Bruesewitz MR, Kofler JM Jr (2006) CT dose reduction and dose management tools: overview of available options. Radiographics 26:503–512

    Article  PubMed  Google Scholar 

  48. Greess H, Nömayr A, Wolf H et al (2002) Dose reduction in CT examination of children by an attenuation-based on-line modulation of tube current (CARE Dose). Eur Radiol 12:1571–1576

    Article  PubMed  Google Scholar 

  49. Greess H, Wolf H, Baum U et al (2000) Dose reduction in computed tomography by attenuation-based on-line modulation of tube current: evaluation of six anatomical regions. Eur Radiol 10:391–394

    Article  CAS  PubMed  Google Scholar 

  50. Greess H, Lutze J, Nomayr A et al (2004) Dose reduction in subsecond multislice spiral CT examination of children by online tube current modulation. Eur Radiol 14:995–999

    Article  CAS  PubMed  Google Scholar 

  51. Geleijns J, Salvadó Artells M, Veldkamp WJ et al (2006) Quantitative assessment of selective in-plane shielding of tissues in computed tomography through evaluation of absorbed dose and image quality. Eur Radio 16:2334–40

    Article  CAS  Google Scholar 

  52. Fricke BL, Donnelly LF, Frush DP et al (2003) In-Plane bismuth breast shields for pediatric CT: effects on dose and imaging quality using experimental and clinical data. AJR Am J Roentgenol 180:407–411

    PubMed  Google Scholar 

  53. Coursey C, Frush D, Yoshizumi T et al (2008) Pediatric chest MDCT and tube current modulation: effect on radiation dose with breast shielding. Pediatric chest MDCT using tube current modulation: effect on radiation dose with breast shielding. AJR Am J Roentgenol 190:54–61

    Article  Google Scholar 

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Frush, D.P. (2008). MDCT in Children: Scan Techniques and Contrast Issues. In: Kalra, M.K., Saini, S., Rubin, G.D. (eds) MDCT. Springer, Milano. https://doi.org/10.1007/978-88-470-0832-8_26

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  • DOI: https://doi.org/10.1007/978-88-470-0832-8_26

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0831-1

  • Online ISBN: 978-88-470-0832-8

  • eBook Packages: MedicineMedicine (R0)

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