CT im Kindes- und Jugendalter

Zusammenfassung

CT-Untersuchungen von Kindern und Jugendlichen sind trotz aller Weiterentwicklungen der CT-Technik immer noch eine Herausforderung. Themen dieses Beitrags sind die Vorbereitung dieser Untersuchungen, dedizierte pädiatrische CT-Protokolle mit dem Hauptfokus auf der Verringerung der Strahlendosis und typische CT-Indikationen.

Abstract

Despite all the advances in CT technology, CT examinations in children and adolescents are still a challenge. This article will discuss child-specific preparation as well as dedicated pediatric CT protocols with a focus on radiation dose reduction using case studies of typical CT indications.

Schlüsselwörter

Computertomografie - Strahlenschutz - Dosisreduktion - Kinder- und Jugendradiologie

Key words

computed tomography - radiation protection - dose reduction - pediatric and adolescent radiology

• Literatur

• 1 Pedersen KD, Jensen J, Hertz H. CT whole-body scanning in pediatric radiology. Pediatr Radiol 1978; 6: 222-229
• 2 Alibek S, Brand M, Suess C. et al. Dose reduction in pediatric computed tomography with automated exposure control. Acad Radiol 2011; 18: 690-693
• 3 Willemink MJ, de Jong PA, Leiner T. et al. Iterative reconstruction techniques for computed tomography Part 1: technical principles. Eur Radiol 2013; 23: 1623-1631
• 4 Bodelle B, Fischbach C, Booz C. et al. Single-energy pediatric chest computed tomography with spectral filtration at 100 kVp: effects on radiation parameters and image quality. Pediatr Radiol 2017; 47: 831-837
• 5 Oztek MA, Noda S, Beauchemin EA. et al. Gentle Touch: Noninvasive Approaches to Improve Patient Comfort and Cooperation for Pediatric Imaging. Top Magn Reson Imaging 2020; 29: 187-195
• 6 ACR Committee on Drugs and Contrast Media of the ACR Commission on Quality and Safety. ACR Manual on Contrast Media. 2023 Im Internet (Stand: 04.04.2023): https://www.acr.org/Clinical-Resources/Contrast-Manual
• 7 Thomas KE, Mann EH, Padfield N. et al. Dual bolus intravenous contrast injection technique for multiregion paediatric body CT. Eur Radiol 2015; 25: 1014-1022
• 8 Bundesamt für Strahlenschutz. Bekanntmachung der aktualisierten diagnostischen Referenzwerte für diagnostische und interventionelle Röntgenanwendungen. 2022 Im Internet (Stand: 04.04.2023): https://www.bfs.de/SharedDocs/Downloads/BfS/DE/fachinfo/ion/drw-roentgen.pdf;jsessionid=223D920B05DCECCEB98A1D8928F5243D.1_cid339?__blob=publicationFile&v=11
• 9 Nikupaavo U, Kaasalainen T, Reijonen V. et al. Lens dose in routine head CT: comparison of different optimization methods with anthropomorphic phantoms. AJR Am J Roentgenol 2015; 204: 117-123
• 10 Miele V, Di Giampietro I, Ianniello S. et al. Diagnostic imaging in pediatric polytrauma management. Radiol Med 2015; 120: 33-49
• 11 Huber-Wagner S, Lefering R, Qvick LM. et al. Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study. Lancet 2009; 373: 1455-1461
• 12 Schmittenbecher PP. S2K-Leitlinie „Polytraumaversorgung im Kindesalter“ AWMF-Reg.-Nr. 006-120. 2020 Im Internet (Stand: 04.04.2023): https://register.awmf.org/assets/guidelines/006-120l_S2k_Polytraumaversorgung-im-Kindesalter_2021-02.pdf
• 13 Hakim W, Kamanahalli R, Dick E. et al. Trauma whole-body MDCT: an assessment of image quality in conventional dual-phase and modified biphasic injection. Br J Radiol 2016; 89: 20160160
• 14 Leung VJ, Grima M, Khan N. et al. Early experience with a split-bolus single-pass CT protocol in paediatric trauma. Clin Radiol 2017; 72: 497-501
• 15 Tsiflikas I, Thater G, Ayx I. et al. Low dose pediatric chest computed tomography on a photon counting detector system – initial clinical experience. Pediatr Radiol 2023;
• 16 Rompel O, Glöckler M, Janka R. et al. Third-generation dual-source 70-kVp chest CT angiography with advanced iterative reconstruction in young children: image quality and radiation dose reduction. Pediatr Radiol 2016; 46: 462-472
• 17 Esser M, Gatidis S, Teufel M. et al. Contrast-Enhanced High-Pitch Computed Tomography in Pediatric Patients Without Electrocardiography Triggering and Sedation: Comparison of Cardiac Image Quality With Conventional Multidetector Computed Tomography. J Comput Assist Tomogr 2017; 41: 165-171
• 18 Han BK, Rigsby CK, Leipsic J. et al. Computed Tomography Imaging in Patients with Congenital Heart Disease, Part 2: Technical Recommendations. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT): Endorsed by the Society of Pediatric Radiology (SPR) and the North American Society of Cardiac Imaging (NASCI). J Cardiovasc Comput Tomogr 2015; 9: 493-513
• 19 Snow A, Milliren CE, Graham DA. et al. Quality of pediatric abdominal CT scans performed at a dedicated childrenʼs hospital and its referring institutions: a multifactorial evaluation. Pediatr Radiol 2017; 47: 391-397
• 20 Nenopoulos A, Beslikas T, Gigis I. et al. The role of CT in diagnosis and treatment of distal tibial fractures with intra-articular involvement in children. Injury 2015; 46: 2177-2180