Multiplanar and Three-dimensional Multi–Detector Row CT of Thoracic Vessels and Airways in the Pediatric Population

Multi–detector row computed tomography (CT) has changed the approach to imaging of thoracic anatomy and disease in the pediatric population. At the author’s institution, multi–detector row CT with multiplanar and three-dimensional reconstruction has become an important examination in the evaluation of systemic and pulmonary vasculature and the tracheobronchial tree. In some clinical situations, multi–detector row CT with reformatted images is obviating conventional angiography, which is associated with higher radiation doses and longer sedation times. Although multi–detector row CT with multiplanar and three-dimensional reconstruction is expanding the applications of CT of the thorax, its role as a diagnostic tool still needs to be better defined. The purposes of this article are to describe how to perform multi–detector row CT with multiplanar and three-dimensional reconstruction in young patients, to discuss various reconstruction techniques available, and to discuss applications in the evaluation of vascular and airways diseases.

© RSNA, 2003

References

  • 1 Lawler LP, Fishman EK. Multi-detector row CT of thoracic disease with emphasis on 3D volume rendering and CT angiography. RadioGraphics 2001; 21:1257- 1273.
  • 2 Ravenel JG, McAdams HP, Remy-Jardin M, Remy J. Multidimensional imaging of the thorax: practical applications. J Thorac Imaging 2001; 16:279-281.
  • 3 Boiselle PM, Reynolds KF, Ernst A. Multiplanar and three-dimensional imaging of the central airways with multidetector CT. AJR Am J Roentgenol 2002; 179:301-308.
  • 4 Kaste SC, Young CW, Holmes TP, Baker DK. Effect of helical CT on the frequency of sedation in pediatric patients. AJR Am J Roentgenol 1997; 168:1001-1003.
  • 5 White KS. Reduced need for sedation in pediatric patients undergoing helical CT of the chest and abdomen. Pediatr Radiol 1995; 25:344-346.
  • 6 Pappas JN, Donnelly LF, Frush DP. Reduced frequency of sedation of young children using new multisection helical CT. Radiology 2000; 215:897-899.
  • 7 American Academy of Pediatrics Committee on Drugs. guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures. Pediatrics 1992; 89:1110-1115.
  • 8 Practice guidelines for sedation and analgesia by non-anesthesiologist: a report by the American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists.Anesthesiology1996; 84:459-471.
  • 9 Frush DP, Bisset GS, III, Hall SC. Pediatric sedation in radiology: the practice of safe sleep. AJR Am J Roentgenol 1996; 167:1381-1387.
  • 10 Cohan RH, Ellis JH, Garner WL. Extravasation of radiographic contrast material: recognition, prevention, and treatment. Radiology 1996; 200:593-604.
  • 11 Stockberger SM, Hickling JA, Liang Y, Ambrosius WT. Spiral CT with ionic and nonionic contrast material: evaluation of patient motion and scan quality. Radiology 1998; 206:631-636.
  • 12 Siegel MJ. Techniques. In: Siegel MJ, eds. Pediatric body CT. Philadelphia, Pa: Lippincott Williams & Wilkins, 1999; 1-41.
  • 13 Bhalla S, Siegel MJ. Multislice computed tomography in pediatrics. In: Silverman PM, eds. Multislice computed tomography: a practical approach to clinical protocols. Philadelphia, Pa: Lippincott Williams & Wilkins, 2002; 231-282.
  • 14 Kaste SC, Young CW. Safe use of power injectors with central and peripheral venous access devices for pediatric CT. Pediatr Radiol 1995; 26:499-501.
  • 15 Silverman PM, Roberts S, Tefft MC, et al. Helical CT of the liver: clinical application of an automated computer technique, Smart Prep, for obtaining images with optimal contrast enhancement. AJR Am J Roentgenol 1995; 165:73-78.
  • 16 Cody DD. AAPM/RSNA physics tutorial for residents: topics in CT—image processing in CT. RadioGraphics 2002; 2:1255-1268.
  • 17 Hu H, He HD, Foley WD, Fox SH. Four multi–detector row helical CT: image quality and volume coverage speed. Radiology 2000; 215:55-62.
  • 18 Rydberg J, Buckwalter KA, Caldemeyer KS, et al. Multisection CT: scanning techniques and clinical applications. RadioGraphics 2000; 20:1787-1806.
  • 19 Donnelly LF, Emery KH, Brody AS, et al. Minimizing radiation dose for pediatric body applications for single-detector helical CT: strategies at a large children’s hospital. AJR Am J Roentgenol 2001; 176:303-306.
  • 20 Frush DP, Slack CC, Hollingsworth CL, et al. Computer-simulated radiation dose reduction for abdominal multidetector CT of pediatric patients. AJR Am J Roentgenol 2002; 179:1107-1113.
  • 21 Haaga JR. Commentary: radiation dose management weighing risk versus benefit. AJR Am J Roentgenol 2001; 177:289-291.
  • 22 Lucaya J, Piqueras J, Garcia-Pena P, Enriquez G, Garcia-Macias M, Sotil J. Low-dose high resolution CT of the chest in children and young adults: dose, cooperation, artifact incidence, and image quality. AJR Am J Roentgenol 2000; 175:985-992.
  • 23 Patterson A, Frush DP, Donnelly L. Helical CT of the body: are settings adjusted for pediatric patients? AJR Am J Roentgenol 2001; 176:297-301.
  • 24 Rogalla P, Stover B, Scheer I, Juran R, Gaedicke G, Hamm B. Low-dose spiral CT: applicability to paediatric chest imaging. Pediatr Radiol 1999; 29:565-569.
  • 25 Slovis TL. The ALARA concept in pediatric CT: myth or reality? (editorial). Radiology 2002; 223:5-6.
  • 26 Rapp-Bernhardt U, Welte T, Doehring W, Kropf S, Bernhardt TM. Diagnostic potential of virtual bronchoscopy: advantages in comparison with axial CT slices, MPR and MIP? Eur Radiol 2000; 10:981-988.
  • 27 Remy-Jardin M, Remy J, Artaud D, Fribourg M, Duchamel A. Volume rendering of the tracheobronchial tree: clinical evaluation of bronchographic image. Radiology 1998; 208:761-770.
  • 28 Lee EY, Siegel MJ, Hildebolt CF, Gutierrez FR. Multidetector CT evaluation of pediatric thoracic aorta anomalies: comparison of axial, multiplanar and 3D images. AJR Am J Roentgenol. (in press).
  • 29 Hopkins KL, Patrick LE, Simoneaux SF, et al. Pediatric great vessel anomalies: initial clinical experience with spiral CT angiography. Radiology 1996; 200:811-815.
  • 30 Katz M, Konen E, Rozenman J, et al. Spiral CT and 3D image reconstruction of vascular rings and associated tracheobronchial anomalies. J Comput Assist Tomogr 1995; 19:564-568.
  • 31 McGuinness , Naidich DP. Multislice computed tomography of the chest. In: Silverman PM, eds. Multislice computed tomography: a practical approach to clinical protocols. Philadelphia, Pa: Lippincott Williams & Wilkins, 2002; 117-167.
  • 32 Sommer T, Rehske W, Holzknecht N, et al. Aortic dissection: a comparative study of diagnosis with spiral CT, multiplanar transesophageal echocardiography, and MR imaging. Radiology 1996; 199:347-352.
  • 33 Zeman RK, Berman PM, Silverman PM, et al. Diagnosis of aortic dissection: value of helical CT with multiplanar reformation and three-dimensional rendering. AJR Am J Roentgenol 1995; 164:1375-1380.
  • 34 Ko SF, Ng SH, Lee TY, et al. Noninvasive imaging of bronchopulmonary sequestration. AJR Am J Roentgenol 2000; 175:1005-1012.
  • 35 Hoffman LV, Kuszyk BS, Mitchell SE, et al. Angioarchitecture of pulmonary AVM malformation characterization using volume-rendered 3D CT angiography. Cardiovasc Intervent Radiol 2000; 23:165.
  • 36 Lawler LP, Fishman EK. Arteriovenous malformations and systemic lung supply: evaluation by multidetector CT and three-dimensional volume rendering. AJR Am J Roentgenol 2002; 178:493-494.
  • 37 Zwetsch B, Wicky S, Meuli R, et al. Three-dimensional image reconstruction of partial anomalous pulmonary venous return to the superior vena cava. Chest 1995; 108:1743-1745.
  • 38 Remy J, Remy-Jardin M, Giraud F, et al. Angiotexture of pulmonary arteriovenous malformation: clinical utility of three-dimensional helical CT. Radiology 1994; 191:657-664.
  • 39 Gilkeson RC, Ciancibello LM, Hejal RB, Montenegro HD, Lange P. Tracheobronchomalacia: dynamic airway evaluation with multidetector CT. AJR Am J Roentgenol 2001; 176:205-221.
  • 40 Remy-Jardin M, Remy J, Artaud D, Fribourg M, Naili A. Tracheobronchial tree: assessment with volume rendering—technical aspects. Radiology 1998; 208:393-398.

Article History

Published in print: Dec 2003