ADVANCES IN PEDIATRICS

Are you aware of the tremendous potential advantages 64 slice CT has to offer your pediatric patients? With scan times of the chest and abdomen averaging approximately five seconds per study, the need for sedation is often eliminated. High quality studies are accomplished with minimal patient cooperation.

Additionally, we must always be cognizant of radiation dosages in these little patients, and strive to minimize their exposure. With decreased scan times, this major concern is dramatically reduced; yet this sophisticated testing can still maximize the information available for harvesting.

New techniques like CT angiography and 3D imaging are the latest additions to the arsenal of weapons that can be utilized by the RADIOLOGIST/PEDIATRICIAN to examine, diagnose, treat and ultimately fight disease in the pediatric population

HOW TO PREPARE A CHILD FOR CT PROCEDURE
If intravenous contrast material is to be used in the exam, the CT staff will need to know whether the child has had a reaction to contrast material in the past; is allergic to iodine or seafood; or has kidney disease. The purpose of asking about allergies is to avoid a possibly serious allergic reaction.

The child may eat and drink as usual and take needed medication as long as no contrast is to be given and no sedative (calming medication) or anesthesia is planned. If either of these situations applies, the parent may be advised about dietary restrictions or receive other instructions. With sedation or anesthesia the child probably will not be allowed to eat for three to six hours, depending on age, before scanning. In general, children who have recently been ill are not sedated or anesthetized. If this is the case or if you suspect the child may be getting sick, you should call the CT staff to see whether the exam should be rescheduled.

For a head or neck scan you will have to remove the child's glasses, any removable dental braces or dentures, and any jewelry. For a scan of any other part of the body, all metal objects should be removed from the area being examined.

HOW IS THE PROCEDURE PERFORMED?
After receiving oral or intravenous contrast material if needed, and a sedative if judged necessary, the child will lie down on the scanner couch and be made as comfortable as possible. The head is supported in a cushion using soft straps to maintain alignment. The exact body position depends on what area is being scanned. You should encourage your child to report any discomfort during positioning because it is important to keep very still during the exam. Once the child is correctly positioned the CT staff will leave the room to begin the scan. For the first scans the couch will move through the scanner to determine its correct starting position for the rest of the scans. The table will then move more slowly as the actual CT scan is performed.

In adults, breath holding is an important way of obtaining high-quality CT images. Most children older than six years are able to hold their breath long enough to complete the scan, although they may need coaching and practice. Younger children may be able to hold their breath when asked, but are not as reliable as older children and may not be able to hold their breath long enough to complete the scan. Irregular breathing can affect the quality of a CT scan, especially one done to evaluate the chest or upper abdomen. It is often better to have young children breathe quietly and regularly during the scan. The technologist will help to decide about this. Modern systems known as multidetector or multislice CT are able to image large regions of the body in a very short time.

After the study is completed you may be asked to wait for a short time while the radiologist checks the scans to make sure they are clear enough to be easily interpreted. Occasionally it is necessary to have a few scans repeated.