Pediatric Body CT

Pediatric body CT began in earnest in 1976 when for the first time a body CT machine was installed in a pediatric institution, the Hospital for Sick Children in Toronto. The first images were received with great enthusiasm. More recently, newer equipment with faster scan times and better resolution has enabled us to delineate disease processes with even greater accuracy. In the past 9 years we have performed more than 5000 body scans in children. With this experience our examination techniques have changed and the indications for CT in children have been modified. CT has come to occupy an important and specific place in the management of pediatric patients. The performance of body CT studies in children is not always easy. Excellent diagnostic studies can be obtained only with a special understanding of the problems of pediatric patients and pediatric pathology. The information contained herein is a review of our experience with pediatric body CT, how we use body CT in children, and its relationship to other modalities in this department.

Section I: Introduction.- 1 General Considerations.- Factors Affecting Choice of Modality.- General Considerations.- Clinical and Radiological Factors.- References.- 2 Technique.- Prescan Preparation.- Patient Care.- Instructions and Monitoring.- Sedation.- Immobilization.- Environment.- Contrast Administration.- Scan Technique.- Computed Radiographs.- Axial Scans.- Postscan Techniques.- Guidance Procedures.- Summary.- Section II: Chest.- 3 Technique.- Window Settings.- Pseudomasses and Anatomical Variations.- Bones.- Vessels.- 4 Mediastinum.- Anatomical Compartments.- Thymus.- Trachea.- Heart and Pericardium.- Mediastinal Masses.- Anterior Mediastinum.- Middle Mediastinum.- Posterior Mediastinum.- Other Masses.- References.- 5 Lung Parenchyma.- Diffuse Parenchymal Disease.- Mass Lesions.- Pulmonary Nodules.- Accuracy.- Appearances.- Technique.- Differentiation from Vessels.- References.- 6 Chest Wall and Pleura.- Superficial Soft Tissues.- Bony Thorax.- Extrapleural Tissues.- Pleura.- Postradiation Changes.- References.- Section III: Abdomen.- 7 Technique.- Gastrointestinal Contrast Material.- Intravenous Contrast Material.- Scan Technique.- 8 Retroperitoneum.- Anatomy.- Pathology.- Lymph Nodes.- Neoplasms.- Sympathetic Nervous System.- Soft Tissues.- Blood Vessels.- Nonpalpable Testis.- References.- 9 Pancreas.- Anatomy.- Relationships.- Size.- Displacements.- Pathology.- Pancreatitis.- Trauma.- Neoplasms.- Cystic Fibrosis.- References.- 10 Adrenals.- Technique.- Anatomy.- Shape and Relationships.- Size.- Hyperplasia.- Pseudotumors.- Neoplasms.- Medullary and Sympathetic Nervous System Lesions.- Adrenocortical Neoplasms.- Miscellaneous.- Adrenal Hemorrhage.- Adrenal Calcification.- References.- 11 Kidneys.- Indications.- Technique.- Anatomy.- Normal Variants and Congenital Anomalies.- Pathology.- Cysts.- Renal Vein Thrombosis.- Attenuation Changes.- Inflammation.- Neoplasia.- Trauma.- References.- 12 Liver.- Anatomy.- Surfaces.- Attenuation.- Vessels.- Lobes.- Pathology.- Diffuse Parenchymal Disease.- Portal Hypertension.- Masses.- Trauma.- References.- 13 Biliary Tract.- Anatomy.- Gallbladder.- Bile Ducts.- Pathology.- Gallbladder.- Bile Ducts.- References.- 14 Spleen.- Anatomy.- Size.- Normal Variations and Congenital Anomalies.- Shape.- Position.- Displacements.- Attenuation.- Pathology.- Neoplasms.- Cysts.- Trauma.- Asplenia/Polysplenia Syndrome.- References.- 15 Pelvic Viscera and Soft Tissues.- Anatomy.- Pelvic Masses.- Presacral Lesions.- Rectal Lesions.- Bladder and Genital Lesions.- Lateral Pelvic Masses.- Abscesses.- Hematomas.- Nonpalpable Testes.- Renal Transplants.- References.- 16 Approach to Abdominal and Pelvic Masses, Inflammation, and Trauma.- Masses.- Older Investigative Modalities.- Newer Investigative Modalities.- Inflammation.- Trauma.- Computed Tomography.- Other Modalities.- Visceral Injuries.- Summary.- References.- 17 Miscellaneous.- Abdominal Wall.- Ascites.- Omentum and Mesentery.- Gastrointestinal Tract.- Conjoined Twins.- References.- Section IV: Neck.- 18 Technique and Anatomy.- Technique.- Sedation and Airway Control.- Scan Technique.- Anatomy.- Posterior.- Anterior.- References.- 19 Larynx.- Case Material.- Summary.- References.- 20 Neck Masses.- Plain Radiographs.- Sonography.- Computed Tomography.- Benign Lesions.- Malignant Lesions.- Other Modalities.- Summary.- References.- Section V: Musculosketal System.- 21 Soft Tissues.- Technique.- Edema, Hematomas, and Infection.- Vascular Lesions.- Nerve Sheath Lesions.- Fibrous Lesions.- Other Malignant Masses.- Neuromuscular Diseases.- Foreign Bodies.- References.- 22 Bones.- Technique.- Trauma.- Inflammation.- Neoplasms.- Benign.- Malignant.- Metastases.- Miscellaneous.- References.- 23 Special Areas.- General Introduction.- Hips.- Congenital Dislocation.- Proximal Focal Femoral Deficiency.- Slipped Upper Femoral Epiphysis.- Loose Bodies.- Miscellaneous.- Sacroiliac Joints.- Trauma.- Neoplasms.- Infection.- Arthritis.- Feet.- Fractures.- Tumors.- Tarsal Coalition.- Miscellaneous.- Spine.- References.