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Paediatric multi-detector row chest CT: what you really need to know.

Young C, Xie C, Owens CM - Insights Imaging (2012)

Bottom Line: Paediatric imaging technique/protocol together with radiation dose reduction is discussed in detail.However, users must be vigilant in their imaging techniques to minimise radiation burden, whilst maintaining good image quality.Main Messages • CT examinations should be clinically justified by the referring clinician and radiologist. • MDCT is invaluable for evaluating the central airway, mediastinal structures and lung parenchyma. • MDCT is more sensitive than plain radiographs in detection of structural changes within the lungs.

View Article: PubMed Central - PubMed

Affiliation: Cardio-thoracic Unit, Great Ormond Street Hospital for Children NHS Trust, London, WC1N, 3JH, UK, carolyn.young16@yahoo.co.uk.

ABSTRACT

Background: The emergence of multi-detector row CT (MDCT) has established and extended the role of CT especially in paediatric chest imaging. This has altered the way in which data is acquired and is perceived as the 'gold standard' in the detection of certain chest pathologies. The range of available post-processing tools provide alternative ways in which CT images can be manipulated for review and interpretation in order to enhance diagnostic accuracy.

Methodology: Paediatric imaging technique/protocol together with radiation dose reduction is discussed in detail. The use of different post-processing tools to best demonstrate the wide range of important congenital anomalies and thoracic pathologies is outlined and presented pictorially.

Conclusion: MDCT with its isotropic resolution and fast imaging acquisition times reduces the need for invasive diagnostic investigations. However, users must be vigilant in their imaging techniques to minimise radiation burden, whilst maintaining good image quality. Main Messages • CT examinations should be clinically justified by the referring clinician and radiologist. • MDCT is invaluable for evaluating the central airway, mediastinal structures and lung parenchyma. • MDCT is more sensitive than plain radiographs in detection of structural changes within the lungs.

No MeSH data available.


Related in: MedlinePlus

Altering the reconstruction algorithm from soft tissue (B30) to a bony filter (B60) increases the edge enhancement between tissue interfaces, resulting in increase in image sharpness, as demonstrated in b when compared to a, when viewed at the same parameter of W1200, C-600. Altering the viewing parameter to W400, C40 on the B30 algorithm highlights the mediastinum and great vessels (c). Scanning parameters: 100 kV, 36 eff mAs, 30 ref mAs, 1.20 CTDIvol, 20 DLP
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Fig1: Altering the reconstruction algorithm from soft tissue (B30) to a bony filter (B60) increases the edge enhancement between tissue interfaces, resulting in increase in image sharpness, as demonstrated in b when compared to a, when viewed at the same parameter of W1200, C-600. Altering the viewing parameter to W400, C40 on the B30 algorithm highlights the mediastinum and great vessels (c). Scanning parameters: 100 kV, 36 eff mAs, 30 ref mAs, 1.20 CTDIvol, 20 DLP

Mentions: Volumetric data acquisition protocol involves a post-contrast spiral acquisition of the entire lung volume at end-inspiration. Using a low dose protocol and thin slice (0.6 mm) collimation, images are reconstructed with overlapping or contiguous slices on soft tissue and high spatial resolution (bony) algorithm for optimal mediastinal and lung parenchymal display respectively [1, 2, 14, 15] (Fig. 1). Where patients are investigated for known or suspected airway disease or where areas of decreased attenuation are seen on the inspiratory images, three evenly spaced end-expiratory slices (at the apices, carina and lung bases) are taken to establish the presence of air trapping. Patients unable to breath-hold are placed in the decubitus position [16–18], with two spaced slices taken in both right and left decubitus positions. The dependent lung behaves in apparent expiration, whilst the non-dependent lung is in inspiration.Fig. 1


Paediatric multi-detector row chest CT: what you really need to know.

Young C, Xie C, Owens CM - Insights Imaging (2012)

Altering the reconstruction algorithm from soft tissue (B30) to a bony filter (B60) increases the edge enhancement between tissue interfaces, resulting in increase in image sharpness, as demonstrated in b when compared to a, when viewed at the same parameter of W1200, C-600. Altering the viewing parameter to W400, C40 on the B30 algorithm highlights the mediastinum and great vessels (c). Scanning parameters: 100 kV, 36 eff mAs, 30 ref mAs, 1.20 CTDIvol, 20 DLP
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369117&req=5

Fig1: Altering the reconstruction algorithm from soft tissue (B30) to a bony filter (B60) increases the edge enhancement between tissue interfaces, resulting in increase in image sharpness, as demonstrated in b when compared to a, when viewed at the same parameter of W1200, C-600. Altering the viewing parameter to W400, C40 on the B30 algorithm highlights the mediastinum and great vessels (c). Scanning parameters: 100 kV, 36 eff mAs, 30 ref mAs, 1.20 CTDIvol, 20 DLP
Mentions: Volumetric data acquisition protocol involves a post-contrast spiral acquisition of the entire lung volume at end-inspiration. Using a low dose protocol and thin slice (0.6 mm) collimation, images are reconstructed with overlapping or contiguous slices on soft tissue and high spatial resolution (bony) algorithm for optimal mediastinal and lung parenchymal display respectively [1, 2, 14, 15] (Fig. 1). Where patients are investigated for known or suspected airway disease or where areas of decreased attenuation are seen on the inspiratory images, three evenly spaced end-expiratory slices (at the apices, carina and lung bases) are taken to establish the presence of air trapping. Patients unable to breath-hold are placed in the decubitus position [16–18], with two spaced slices taken in both right and left decubitus positions. The dependent lung behaves in apparent expiration, whilst the non-dependent lung is in inspiration.Fig. 1

Bottom Line: Paediatric imaging technique/protocol together with radiation dose reduction is discussed in detail.However, users must be vigilant in their imaging techniques to minimise radiation burden, whilst maintaining good image quality.Main Messages • CT examinations should be clinically justified by the referring clinician and radiologist. • MDCT is invaluable for evaluating the central airway, mediastinal structures and lung parenchyma. • MDCT is more sensitive than plain radiographs in detection of structural changes within the lungs.

View Article: PubMed Central - PubMed

Affiliation: Cardio-thoracic Unit, Great Ormond Street Hospital for Children NHS Trust, London, WC1N, 3JH, UK, carolyn.young16@yahoo.co.uk.

ABSTRACT

Background: The emergence of multi-detector row CT (MDCT) has established and extended the role of CT especially in paediatric chest imaging. This has altered the way in which data is acquired and is perceived as the 'gold standard' in the detection of certain chest pathologies. The range of available post-processing tools provide alternative ways in which CT images can be manipulated for review and interpretation in order to enhance diagnostic accuracy.

Methodology: Paediatric imaging technique/protocol together with radiation dose reduction is discussed in detail. The use of different post-processing tools to best demonstrate the wide range of important congenital anomalies and thoracic pathologies is outlined and presented pictorially.

Conclusion: MDCT with its isotropic resolution and fast imaging acquisition times reduces the need for invasive diagnostic investigations. However, users must be vigilant in their imaging techniques to minimise radiation burden, whilst maintaining good image quality. Main Messages • CT examinations should be clinically justified by the referring clinician and radiologist. • MDCT is invaluable for evaluating the central airway, mediastinal structures and lung parenchyma. • MDCT is more sensitive than plain radiographs in detection of structural changes within the lungs.

No MeSH data available.


Related in: MedlinePlus