From the RSNA refresher courses. Challenges of pediatric spiral CT

Spiral technology has expanded the usefulness of computed tomography (CT) in the evaluation of pediatric diseases. Even though spiral CT requires shorter total scanning times, image degradation by patient motion is still a problem in very young patients, and oral and intravenous sedatives are administered to minimize this problem. Optimal parenchymal enhancement depends on the amount and injection rate of contrast material and the timing of the onset of scanning. All these are more variable in studies of children than in adults, with the latter being the most complicated. Spiral CT of the pediatric chest is most useful for evaluating anastomotic dehiscence and stenosis in lung transplant recipients, pulmonary nodules in children with malignant disease likely to disseminate to the lung, and great vessel anomalies; for staging pulmonary tumors; and for dynamic imaging to identify various diseases that cause pulmonary dysfunction. Important applications of spiral CT of the pediatric abdomen and pelvis include evaluating the liver for acquired vascular abnormalities and vascular tumors, staging and preoperative assessment of renal tumors, and evaluating inflammatory pelvic lesions.