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Chest CTA in children younger than two years - a retrospective comparison of three contrast injection protocols

Eszter Nagy1, Sebastian Tschauner2, Robert Marterer2

  • 1Division of Paediatric Radiology, Department of Radiology, Medical University Graz, Graz, Austria. eszter.nagy@medunigraz.at.

Scientific Reports
|December 4, 2019
PubMed

Insights

The microbolus technique (MBT) for thoracic CT angiography in young children uses less contrast agent while maintaining diagnostic image quality. MBT also reduces image artifacts compared to standard and fixed-bolus delay protocols.

Area of Science:

  • Radiology
  • Pediatric Imaging
  • Medical Imaging

Background:

  • Thoracic CT angiography (CTA) in pediatric patients (<2 years) presents challenges in balancing diagnostic yield with minimizing side effects.
  • Optimizing contrast agent (CA) delivery is crucial for effective pediatric CTA.

Purpose of the Study:

  • To compare three contrast agent injection protocols for pediatric thoracic CTA.
  • Evaluate image quality, contrast enhancement, and CA characteristics across different protocols.

Main Methods:

  • Seventy pediatric (<2 years) chest CTA scans were divided into three groups: microbolus technique (MBT), standard CTA, and fixed-bolus delay.
  • Objective image quality metrics (peak enhancement, noise, SNR, CNR) and subjective observer scores for image quality and artifacts were analyzed.

Main Results:

  • The MBT group used significantly less contrast agent (9.0±3.7 ml) compared to the standard protocol (12.9±4.5 ml).
  • All protocols achieved diagnostic vessel enhancement (>400 HU) in thoracic vessels.
  • The MBT group demonstrated superior subjective image quality and fewer artifacts.

Conclusions:

  • The microbolus technique is a viable and effective protocol for pediatric thoracic CTA.
  • MBT offers reduced contrast agent volume and improved image quality, making it advantageous for young children.

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