Perera Molligoda Arachchige Arosh S, Verma Yash
Faculty of Medicine, Humanitas University, Pieve Emanuele 20072, Italy.
Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States.
World J Clin Pediatr. 2025 Mar 9;14(1):99288. doi: 10.5409/wjcp.v14.i1.99288.
Photon-counting computed tomography (PCCT) represents a significant advancement in pediatric cardiovascular imaging. Traditional CT systems employ energy-integrating detectors that convert X-ray photons into visible light, whereas PCCT utilizes photon-counting detectors that directly transform X-ray photons into electric signals. This direct conversion allows photon-counting detectors to sort photons into discrete energy levels, thereby enhancing image quality through superior noise reduction, improved spatial and contrast resolution, and reduced artifacts. In pediatric applications, PCCT offers substantial benefits, including lower radiation doses, which may help reduce the risk of malignancy in pediatric patients, with perhaps greater potential to benefit those with repeated exposure from a young age. Enhanced spatial resolution facilitates better visualization of small structures, vital for diagnosing congenital heart defects. Additionally, PCCT's spectral capabilities improve tissue characterization and enable the creation of virtual monoenergetic images, which enhance soft-tissue contrast and potentially reduce contrast media doses. Initial clinical results indicate that PCCT provides superior image quality and diagnostic accuracy compared to conventional CT, particularly in challenging pediatric cardiovascular cases. As PCCT technology matures, further research and standardized protocols will be essential to fully integrate it into pediatric imaging practices, ensuring optimized diagnostic outcomes and patient safety.
光子计数计算机断层扫描（PCCT）是儿科心血管成像领域的一项重大进展。传统CT系统使用能量积分探测器，将X射线光子转换为可见光，而PCCT则利用光子计数探测器直接将X射线光子转换为电信号。这种直接转换使光子计数探测器能够将光子分类到离散的能量水平，从而通过卓越的降噪、提高空间和对比度分辨率以及减少伪影来提高图像质量。在儿科应用中，PCCT具有诸多优势，包括更低的辐射剂量，这可能有助于降低儿科患者患恶性肿瘤的风险，对于那些从小就反复接受辐射的患者可能更有益处。更高的空间分辨率有助于更好地显示小结构，这对于诊断先天性心脏缺陷至关重要。此外，PCCT的光谱功能可改善组织特征描述，并能够创建虚拟单能图像，增强软组织对比度并可能减少造影剂剂量。初步临床结果表明，与传统CT相比，PCCT提供了更高的图像质量和诊断准确性，尤其是在具有挑战性的儿科心血管病例中。随着PCCT技术的成熟，进一步的研究和标准化方案对于将其全面整合到儿科成像实践中至关重要，以确保优化诊断结果和患者安全。
