First experiences with multidetector CT in traumatized children

Radiological evaluation of the posterior pelvic ring in paediatric patients: Results of a retrospective study developing age- and gender-related non-osseous baseline characteristics in paediatric pelvic computed tomography - References for suspected sacroiliac joint injury

INTRODUCTION

The prevalence of paediatric pelvic injury is low, yet they are often indicative of accompanying injuries, and an instable pelvis at presentation is related to long-term poor outcome. Judging diastasis of the sacroiliac joint in paediatric pelvic computed tomography is challenging, as information on their normal appearance is scarce. We therefore sought to generate age- and gender-related standard width measurements of the sacroiliac joint in children for comparison.

PATIENTS AND METHODS

A total of 427 pelvic computed tomography scans in paediatric patients (<18 years old) were retrospectively evaluated. After applying exclusion criteria, 350 scans remained for measurements. Taking a standard approach we measured the sacroiliac joint width bilaterally in axial and coronal planes.

RESULTS

We illustrate age- and gender-related measurements of the sacroiliac joint width as a designated continuous 3rd, 15th, 50th, 85th and 97th centile graph, respectively. Means and standard deviations in the joint width are reported for four age groups. There are distinct changes in the sacroiliac joint's appearance during growth. In general, male children exhibit broader sacroiliac joints than females at the same age, although this difference is significant only in the 11 to 15-year-old age group.

CONCLUSION

The sacroiliac joint width in children as measured in coronal and axial CT scans differs in association with age and gender. When the sacroiliac joint width is broader than the 97th centile published in our study, we strongly encourage considering a sacroiliac joint injury.

Effective dose estimation in whole-body multislice CT in paediatric trauma patients

BACKGROUND

The number of multislice CT (MSCT) scans performed in polytraumatized children has increased rapidly. There is growing concern regarding the radiation dose in MSCT and its long-term consequences, especially in children.

OBJECTIVE

To determine the effective dose to polytraumatized children who undergo whole-body MSCT.

MATERIALS AND METHODS

A total of 51 traumatized children aged 0-16 years underwent a polytrauma protocol CT scan between November 2004 and August 2006 at our institution. The effective dose was calculated retrospectively by a computer program (CT-Expo 1.5, Hannover, Germany).

RESULTS

The mean effective dose was 20.8 mSv (range 8.6-48.9 mSv, SD +/- 7.9 mSv). There was no statistically significant difference in the effective dose between male and female patients.

CONCLUSION

Whole-body MSCT is a superior diagnostic tool in polytraumatized children with 20.8 mSv per patient being a justified mean effective dose. In a potentially life-threatening situation whole-body MSCT provides the clinicians with relevant information to initiate life-saving therapy. Radiologists should use special paediatric protocols that include dose-saving mechanisms to keep the effective dose as low as possible. Further studies are needed to examine and advance dose-saving strategies in MSCT, especially in children.

Pediatric abdominal applications of multidetector-row CT

The introduction of multidetector technology of computed tomography (CT) into clinical practice has increased using CT as modality of choice for most body parts. In spite of some disadvantages of CT such as radiation exposure and using iodinated contrast medium, some facilities gathered by multidetector computed tomography (MDCT) such as faster scanning time and high-resolution imaging technique have improved pediatric CT applications. Less using intravenous and oral contrast medium, less sedation rate, decreased radiation exposure are very practical advantages of MDCT in abdominal imaging of pediatric population. In this review, technical details of these advantages of MDCT for pediatric population and some examples of improved imaging and diagnostic capabilities arising from MDCT for pediatric abdominal applications will be presented.