Related Experiment Videos
Pediatric pulmonary disease: assessment with high-resolution ultrafast CT
D A Lynch1, R C Brasch, K A Hardy
1Department of Radiology, University of California Medical Center, San Francisco.
Insights
High-resolution computed tomography (HRCT) provides detailed lung imaging for children. This ultrafast CT technique detects and characterizes pulmonary disease earlier and more accurately than standard chest X-rays.
Area of Science:
- Pediatric Radiology
- Pulmonary Medicine
- Medical Imaging
Background:
- High-resolution computed tomography (HRCT) is a standard for adult pulmonary parenchymal disease assessment.
- Pediatric lung imaging often relies on standard chest radiography, which may lack detail.
Purpose of the Study:
- To evaluate the feasibility and diagnostic utility of ultrafast, high-resolution computed tomography (HRCT) for assessing pulmonary parenchymal disease in pediatric patients.
- To compare HRCT findings with chest radiographs and clinical diagnoses in children.
Main Methods:
- Ultrafast CT with 3-mm collimation and 100-msec scan time was used to acquire HRCT scans in 36 children.
- HRCT scans and chest radiographs were reviewed in a blinded manner.
- Abnormalities were categorized into interstitial, airspace, and airway processes.
Main Results:
- Nine children with normal chest radiographs showed abnormalities on HRCT.
- HRCT revealed a greater extent of lung abnormality than chest radiography in five patients.
- HRCT accurately characterized the type of lung process in 24 of 30 patients.
- Early HRCT findings in cystic fibrosis included lobular air trapping and bronchial wall thickening.
Conclusions:
- Ultrafast HRCT is a feasible technique for pediatric lung imaging, including in children unable to hold their breath.
- HRCT enables earlier detection, characterization, and assessment of the extent of pulmonary disease in children.
- HRCT offers superior diagnostic information compared to chest radiography for pediatric lung conditions.
Abstract:
High-resolution computed tomography (HRCT) is widely used to assess pulmonary parenchymal disease in adults. The authors used ultrafast CT with 3-mm collimation and a 100-msec scan time to obtain HRCT scans in 36 children (mean age, 49.4 months). Clinical diagnoses included normal lungs (n = 6), cystic fibrosis (n = 12), obliterative bronchiolitis (n = 6), idiopathic pulmonary hemosiderosis (n = 2), and other lung diseases (n = 10). The HRCT scans and chest radiographs were reviewed separately in blinded fashion. Pulmonary parenchymal abnormalities were categorized into interstitial, airspace, and airway processes. Nine patients with normal chest radiographs had abnormal HRCT scans. In five other patients, the extent of abnormal lung parenchyma was considerably greater on HRCT scans than on chest radiographs. HRCT scans allowed accurate characterization of the type of lung process in 24 of 30 patients when compared with clinical or biopsy findings. Early HRCT findings in cystic fibrosis included lobular air trapping, bronchial wall thickening, and centrilobular nodules. The use of cine CT with high-resolution techniques is feasible in children too young or too sick to hold their breath. HRCT may enable early detection and characterization of pulmonary disease and depiction of the extent of lung abnormality.