Technique and clinical applications of full-inflation and end-exhalation controlled-ventilation chest CT in infants and young children

• Published in: Pediatric radiology 2001-06, Vol.31 (6), p.413-422
• Main Authors: LONG, Frederick R, CASTILE, Robert G
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Respiration; Respiratory system; Tomography, X-Ray Computed - methods
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s002470100462

The inability of young children to cooperate with breath holding limits the usefulness of chest CT. 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. 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. 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. 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.