Imaging pediatric acute head trauma using 100-kVp low dose CT with adaptive statistical iterative reconstruction...

To demonstrate the ability of achieving low dose and high-quality head CT images for children with acute head trauma using 100 kVp and adaptive statistical iterative reconstruction (ASIR-V) algorithm in single rotation on a 16 cm wide-detector system.

We retrospectively analyzed the CT dose index (CTDI) and image quality of 104 children aged 0-6 years with acute head trauma (1 hour -3 days) in two groups: Group 1(n = 50) on a 256-row CT with single rotation at a reduced-dose of 100 kVp/240 mA and reconstructed using ASIR-V at 70%level; Group 2(n = 54) on a 64-row CT with multiple rotations at a standard dose of 120 kVp/ 180mA and reconstructed using a conventional filtered back-projection (FBP). Both groups used the 0.5 s/r axial scan mode. CT dose index (CTDI) and quantitative image quality measurements were compared using the Student t test; qualitative image quality comparison was carried out using Mann-Whitney rank test and the inter-reviewer agreement was evaluated using Kappa test.

The exposure time was 0.5 s for Group 1 and 3.27±0.29 s for Group 2. The CTDI in Group 1 was 9.74±0.86mGy, 36.38%lower than the 15.31mGy in Group 2 (p < 0.001). Group 1 and Group 2 had similar artifact index (2.06±1.06 vs. 2.37±1.18) in the cerebellar hemispheres, and similar contrast-to-noise ratio (2.32±0.83 vs. 1.69±0.68), (1.47±0.72 vs. 1.10±0.43) respectively for cerebellum and thalamus (p > 0.05). Image quality was acceptable for diagnosis, and motion artifacts were reduced in Group 1 (p < 0.001).

Single rotation CT with 100 kVp and 70%ASIR-V on 16 cm wide-detector CT reduces radiation dose and motion artifacts for children with acute head trauma without compromising diagnostic quality as compared with standard dose protocol. Thus, it provides a novel imaging method in management of pediatric acute head trauma.