Pediatric Radiology

, Volume 39, Issue 5, pp 485–496

The imaging of paediatric thoracic trauma

  • Michael A. Moore
  • E. Christine Wallace
  • Sjirk J. Westra
Review

Abstract

Major chest trauma in a child is associated with significant morbidity and mortality. It is most frequently encountered within the context of multisystem injury following high-energy trauma such as a motor vehicle accident. The anatomic-physiologic make-up of children is such that the pattern of ensuing injuries differs from that in their adult counterparts. Pulmonary contusion, pneumothorax, haemothorax and rib fractures are most commonly encountered. Although clinically more serious and potentially life threatening, tracheobronchial tear, aortic rupture and cardiac injuries are seldom observed. The most appropriate imaging algorithm is one tailored to the individual child and is guided by the nature of the traumatic event as well as clinical parameters. Chest radiography remains the first and most important imaging tool in paediatric chest trauma and should be supplemented with US and CT as indicated. Multidetector CT allows for the accurate diagnosis of most traumatic injuries, but should be only used in selected cases as its routine use in all paediatric patients would result in an unacceptably high radiation exposure to a large number of patients without proven clinical benefit. When CT is used, appropriate modifications should be incorporated so as to minimize the radiation dose to the patient whilst preserving diagnostic integrity.

Keywords

Chest Trauma Multidetector CT Children 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Michael A. Moore
    • 1
  • E. Christine Wallace
    • 2
  • Sjirk J. Westra
    • 1
  1. 1.Department of RadiologyMassachusetts General Hospital and Harvard Medical SchoolBostonUSA
  2. 2.Department of RadiologyUMass Memorial Medical Center and University of Massachusetts Medical SchoolWorcesterUSA

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