Dynamic Pulmonary CT of Children

Abstract

Wide-detector dynamic CT is ideal for evaluation of the airway and lungs in infants and small children with persistent respiratory distress. Effective doses are low, typically less than 2 mSv.

Dynamic expiratory CT: An effective non‐invasive diagnostic exam for fragile children with suspected tracheo‐bronchomalacia

“…As previously suggested by Greenberg S.B. et al, our study confirmed that congenital heart disease is often associated with airway abnormalities and in particular left bronchomalacia was described for almost all children previously surgically treated …”

“…et al, our study confirmed that congenital heart disease is often associated with airway abnormalities and in particular left bronchomalacia was described for almost all children previously surgically treated. 4 In the majority of cases (89%) the agreement between DB and the dynamic CT scan was great and both agreed when negative or described the same airway malformation. This encouraging result confirms in children what previously described in 29 adults by Lee K.S.…”

“…About CT, Lee defined the techniques currently used for evaluating TBM . Greenberg illustrated a continuous scanning technique by wide‐detector scanners, however, literature is still scarse on its accuracy in direct comparison with the reference “gold‐standard” of bronchoscopy in children . A recent study from Ngerncham et al reported good correlation between CT and DB in a small selected population with TBM and esophageal atresia …”

“…3 Greenberg illustrated a continuous scanning technique by wide-detector scanners, however, literature is still scarse on its accuracy in direct comparison with the reference "goldstandard" of bronchoscopy in children. 4…”

High-pitch CT, decreasing need for sedation and its potential side effects: some practical considerations and future directions

“…Aided by sedation or anesthesia, we are now able to routinely acquire motionless images of the tracheobronchial tree at full inspiration and end-expiration [42] in a cross-sectional format [17][18][19]43]; however these acquisitions do not truly investigate the dynamic nature of tracheo-bronchomalacia. To address this, others have developed free-breathing cine chest CT [44,45] and "four-dimensional" CT on a scanner with enough detectors to cover the relevant anatomy without need for table motion [9,[46][47][48][49]. Yet, I have found that my results with these techniques usually did not affect the clinical management of dynamic airway collapse because most children eventually outgrow this condition and bronchoscopy has remained the diagnostic gold standard for this condition at my hospital [50].…”