Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave., Boston, MA, 02215, USA.
, Queens, NY, USA.
Pediatr Radiol. 2023 Jun;53(7):1260-1269. doi: 10.1007/s00247-022-05451-2. Epub 2022 Jul 22.
Pulmonary embolism (PE) is a potentially life-threatening condition that requires immediate medical intervention. Although PE was previously thought to occur infrequently in the pediatric population, recent studies have found a higher-than-expected prevalence of PE in the pediatric population of up to 15.5%. The imaging modality of choice for detecting PE in the pediatric population is multi-detector CT angiography, although MRI is assuming a growing and more important role as a potential alternative modality. Given the recent advances in both computed tomography pulmonary angiography (CTPA) and MRI techniques, a growing population of pediatric patients with complex comorbidities (such as children with a history of surgeries for congenital heart disease repair), and the recent waves of coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C), which are associated with increased risk of PE, there is new and increased need for an up-to-date review of practical CT and MRI protocols for PE evaluation in children. This article provides guidance for up-to-date CT and MR imaging techniques, reviews key recent studies on the imaging of pediatric PE, and discusses relevant pediatric PE imaging pearls and pitfalls, in hopes of providing readers with up-to-date and accurate practice for imaging evaluation of PE in children.
肺栓塞（PE）是一种潜在的危及生命的疾病，需要立即进行医学干预。尽管以前认为 PE 在儿科人群中很少发生，但最近的研究发现，儿科人群中 PE 的患病率高于预期，高达 15.5%。在儿科人群中检测 PE 的首选影像学方法是多排 CT 血管造影术，尽管 MRI 作为一种潜在的替代方法，其作用正在不断扩大和变得更加重要。鉴于 CT 肺动脉造影（CTPA）和 MRI 技术的最新进展、患有复杂合并症的儿科患者人群不断增加（例如有先天性心脏病修复手术史的儿童），以及最近的 2019 年冠状病毒病（COVID-19）和儿童多系统炎症综合征（MIS-C）浪潮，这些都与 PE 的风险增加有关，因此，迫切需要对儿童 PE 评估的实用 CT 和 MRI 方案进行最新的审查。本文提供了针对最新 CT 和 MR 成像技术的指导，回顾了有关儿科 PE 影像学的关键最新研究，并讨论了相关的儿科 PE 影像学要点和陷阱，希望为读者提供有关儿童 PE 影像学评估的最新和准确的实践指导。
