F R Long1, R G Castile. 1. Children's Radiological Institute, Children's Hospital Columbus, OH, 43205-2696, USA. Flong@chi.osu.edu
Abstract
BACKGROUND: The inability of young children to cooperate with breath holding limits the usefulness of chest CT. OBJECTIVE: To describe the technique and utility of a non-invasive method called controlled-ventilation CT (CVCT) for obtaining motion-free full-inflation and end-exhalation images of the lung in infants and young children. MATERIALS AND METHODS: Eighty-seven children (ages 1 week to 5 years, mean 2 years) underwent CVCT of the chest during suspended respiration at full-lung inflation and end-exhalation for a variety of clinical indications. Respiratory pauses were produced using conscious sedation and positive-pressure face-mask ventilation. Forty-one of 87 children had recordings of respiratory motion during CVCT. RESULTS: Respiratory pause lengths increased with age (P < 0.003), were highly reproducible (r = 0.85), and lasted sufficiently long to be practical for full-inflation (24 +/- 9 s) and end-exhalation (12 +/- 5 s) CT scanning. Full-inflation CVCT was useful in evaluating tracheal and bronchial stenosis, bronchial wall thickening, early bronchiectasis, bronchial fistula, extent of interstitial fibrosis, and lung nodules. End-exhalation CVCT was useful in evaluating tracheomalacia and air trapping. CONCLUSION: Controlled-ventilation chest CT is a practical and reliable technique that promises to be clinically useful for a number of clinical indications in infants and young children.
BACKGROUND: The inability of young children to cooperate with breath holding limits the usefulness of chest CT. OBJECTIVE: To describe the technique and utility of a non-invasive method called controlled-ventilation CT (CVCT) for obtaining motion-free full-inflation and end-exhalation images of the lung in infants and young children. MATERIALS AND METHODS: Eighty-seven children (ages 1 week to 5 years, mean 2 years) underwent CVCT of the chest during suspended respiration at full-lung inflation and end-exhalation for a variety of clinical indications. Respiratory pauses were produced using conscious sedation and positive-pressure face-mask ventilation. Forty-one of 87 children had recordings of respiratory motion during CVCT. RESULTS: Respiratory pause lengths increased with age (P < 0.003), were highly reproducible (r = 0.85), and lasted sufficiently long to be practical for full-inflation (24 +/- 9 s) and end-exhalation (12 +/- 5 s) CT scanning. Full-inflation CVCT was useful in evaluating tracheal and bronchial stenosis, bronchial wall thickening, early bronchiectasis, bronchial fistula, extent of interstitial fibrosis, and lung nodules. End-exhalation CVCT was useful in evaluating tracheomalacia and air trapping. CONCLUSION: Controlled-ventilation chest CT is a practical and reliable technique that promises to be clinically useful for a number of clinical indications in infants and young children.
Authors: Bonnie W Ramsey; Susan Banks-Schlegel; Frank J Accurso; Richard C Boucher; Garry R Cutting; John F Engelhardt; William B Guggino; Christopher L Karp; Michael R Knowles; Jay K Kolls; John J LiPuma; Susan Lynch; Paul B McCray; Ronald C Rubenstein; Pradeep K Singh; Eric Sorscher; Michael Welsh Journal: Am J Respir Crit Care Med Date: 2012-02-03 Impact factor: 21.405
Authors: Shahid I Sheikh; Frederick R Long; Robert Flucke; Nancy A Ryan-Wenger; Don Hayes; Karen S McCoy Journal: Lung Date: 2015-03-12 Impact factor: 2.584