Pediatric CT of the Lung: Influences on Image Quality

• 作者: Enno Stranzinger Jennifer Larissa Cullmann Rainer Wolf Ralph Herrmann Sebastian Tobias Schindera Shu-Fang Hsu Schmitz
• 来源期刊: 放射学期刊(英文)
• 学科: 医学
• 关键词: CT LUNG IMAGE QUALITY CHILDREN
• 年，卷（期）: 2013,（1）
• 页码范围: 45-50
• 页数: 6页
• 分类号: R73

摘要

Objective: To assess influential factors of CT on image quality of the lung in children. Materials and methods: Retrospective evaluation of 82 consecutive chest-CT-scans in 50 children (1-16 years, 17 females and 33 males). Two pediatric radiologists evaluated in consensus the subjective image quality on lung windows using a 4-point scale (1 = very good, 2 = good, 3 = moderate, 4 = poor). Ventilation, motion artifacts and beam hardening artifact were included in this score. The effects of the following factors were evaluated: 1) CT-settings (tube energy, tube current);2) Patient’s age, weight, chest size, ventilation;3) Artifacts of devices, tubes and lines;4) Combination MRI of the abdomen prior to CT of the chest with the same sedation/anesthesia in oncological patients. Results: The odds of having a better image quality increase with patient’s age, weight and chest diameter in a multiple-factor model. There was no difference between tube current protocols. In infants (15 kg) subjective image quality was good in only 1 (8%), moderate in 8 (67%) and poor in 3 (25%) scans. In childhood and adolescence (15 - 90 kg) 25 (36%) scans were very good, 28 (40%) good, 15 (21%) moderate and 2 (3%) poor. Artifacts of tubes and lines have no statistical significant influence on image quality. Lower lung densities were related to better ventilation and older children. Conclusion: Increasing dose parameters may not increase necessarily subjective image quality in infants (15 kg), rather than good ventilation, optimal preparation and avoiding artifacts. A possible explanation of the rather moderate image quality in infants may be the alveolar stage of the lung. Up to two years of age the lung has a high specific lung volume per kg and a low total lung volume with a low alveolar surface.