Technique, pitfalls, quality, radiation dose and findings of dynamic 4-dimensional computed tomography for airway imaging in infants and children.
Savvas AndronikouMark ChopraSimon Langton-HewerPia MaierJon GreenEmma NorburySarah PriceMary SmailPublished in: Pediatric radiology (2019)
This retrospective review of 33 children's dynamic 4-dimensional (4-D) computed tomography (CT) images of the airways, performed using volume scanning on a 320-detector array without anaesthesia (free-breathing) and 1.4-s continuous scanning, was undertaken to report technique, pitfalls, quality, radiation doses and findings. Tracheobronchomalacia (airway diameter collapse >28%) was recorded. Age-matched routine chest CT scans and bronchograms acted as benchmarks for comparing effective dose. Pitfalls included failure to administer intravenous contrast, pull back endotracheal tubes and/or remove nasogastric tubes. Twenty-two studies (67%) were diagnostic. Motion artefact was present in 16 (48%). Mean effective dose: dynamic 4-D CT 1.0 mSv; routine CT chest, 1.0 mSv, and bronchograms, 1.4 mSv. Dynamic 4-D CT showed tracheobronchomalacia in 20 patients (61%) and cardiovascular abnormalities in 12 (36%). Fourteen children (70%) with tracheobronchomalacia were managed successfully by optimising conservative management, 5 (25%) underwent surgical interventions and 1 (5%) died from the presenting disorder.
Keyphrases
- computed tomography
- dual energy
- image quality
- contrast enhanced
- positron emission tomography
- magnetic resonance imaging
- high resolution
- young adults
- end stage renal disease
- magnetic resonance
- low dose
- physical activity
- deep learning
- chronic kidney disease
- ejection fraction
- cystic fibrosis
- clinical practice
- single cell
- high throughput
- high dose
- optical coherence tomography
- case report
- convolutional neural network
- electron microscopy
- mass spectrometry