Hellinger Jeffrey C, Pena Andres, Poon Michael, Chan Frandics P, Epelman Monica
Department of Radiology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Radiol Clin North Am. 2010 Mar;48(2):439-67, x. doi: 10.1016/j.rcl.2010.03.005.
Whether congenital or acquired, timely recognition and management of disease is imperative, as hemodynamic alterations in blood flow, tissue perfusion, and cellular oxygenation can have profound effects on organ function, growth and development, and quality of life for the pediatric patient. Ensuring safe computed tomographic angiography (CTA) practice and "gentle" pediatric imaging requires the cardiovascular imager to have sound understanding of CTA advantages, limitations, and appropriate indications as well as strong working knowledge of acquisition principles and image post processing. From this vantage point, CTA can be used as a useful adjunct along with the other modalities. This article presents a summary of dose reduction CTA methodologies along with techniques the authors have employed in clinical practice to achieve low-dose and ultralow-dose exposure in pediatric CTA. CTA technical principles are discussed with an emphasis on the low-dose methodologies and safe contrast medium delivery strategies. Recommended parameters for currently available multidetector-row computed tomography scanners are summarized alongside recommended radiation and contrast medium parameters. In the second part of the article an overview of pediatric CTA clinical applications is presented, illustrating low-dose and ultra-low dose techniques, with an emphasis on the specific protocols.
无论是先天性还是后天性疾病，及时识别和处理都至关重要，因为血流、组织灌注和细胞氧合方面的血流动力学改变会对小儿患者的器官功能、生长发育和生活质量产生深远影响。确保安全的计算机断层血管造影（CTA）操作以及“轻柔”的儿科成像要求心血管成像人员充分了解CTA的优势、局限性和适用指征，以及对采集原则和图像后处理有扎实的工作知识。从这个角度来看，CTA可以与其他检查方法一起作为有用的辅助手段。本文总结了降低剂量的CTA方法以及作者在临床实践中用于实现儿科CTA低剂量和超低剂量曝光的技术。讨论了CTA技术原理，重点是低剂量方法和安全造影剂输送策略。总结了当前可用的多排螺旋CT扫描仪的推荐参数以及推荐的辐射和造影剂参数。在文章的第二部分，介绍了儿科CTA临床应用的概述，展示了低剂量和超低剂量技术，重点是具体方案。
