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Multislice CT in congenital bronchopulmonary malformations in children

La TC multistrato nello studio delle malformazioni congenite broncopolmonari in età pediatrica

  • Paediatric Radiology / Radiologia Pediatrica
  • Published:
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Abstract

Congenital bronchopulmonary malformations encompass a wide spectrum of pathologies involving the lungs, trachea and bronchi, pulmonary vessels, and oesophagus. These developmental lesions are often isolated, but the association of two or more anomalies is not infrequent. Contrast-enhanced multidetector computed tomography (MDCT), thanks to multiplanar and 3D reconstructions, allows for detailed studies of these malformations, achieving better accuracy compared with conventional techniques such as chest X-ray, fluoroscopy, ventilation and perfusion scintigraphy and ultrasonography. MDCT is characterised by fast data acquisition and does not require sedation in the majority of cases. The main drawbacks of MDCT are the use of ionising radiation and — in many cases —contrast media. Recently, improved CT scanners and optimised CT protocols have made available to children all the benefits of MDCT, thanks to a significant reduction in radiation dose and an improved risk-benefit ratio. The aim of our paper was to evaluate MDCT in children with bronchopulmonary malformations by reporting our experience (about 2,400 studies in 30 months with a 64-slice MDCT scanner) and comparing it with the available literature.

Riassunto

Le malformazioni congenite broncopolmonari rappresentano un ampio spettro di patologie che interessano il parenchima polmonare, il sistema vascolare, le vie aeree centrali e l’esofago. I pazienti affetti presentano quadri malformativi semplici o complessi, rispettivamente caratterizzati da una o più anomalie associate. La tomografia computerizzata (TC) volumetrica multidettetore (MDCT) con mezzo di contrasto permette di analizzare dettagliatamente le strutture toraciche coinvolte nelle malformazioni, con ricostruzioni multiplanari e 3D, con un’accuratezza superiore ad altre indagini tradizionalmente utilizzate tra cui il radiogramma toracico, gli studi fluoroscopici, l’ecografia e la scintigrafia ventilatoria perfusionale. Inoltre la rapidità di acquisizione dei dati consente di evitare nella maggior parte dei casi la sedazione del bambino. Lo svantaggio è rappresentato dall’utilizzo di radiazioni ionizzanti e dalla necessità di somministrare mezzo di contrasto per via endovenosa. Recentemente l’evoluzione tecnologica degli scanner TC e la definizione di protocolli pediatrici dedicati ha permesso una significativa riduzione della dose assorbita, pertanto oggi è possibile usufruire delle potenzialità della MDCT nello studio del torace del bambino con un rapporto rischio-beneficio ragionevolmente vantaggioso. Il nostro articolo si propone di valutare i differenti aspetti dell’impiego della TC sul bambino analizzando la letteratura e confrontandola con l’esperienza personale, unica in Italia: circa 2400 TC del torace in 30 mesi in pazienti compresi tra 1 giorno e 16 anni con un apparecchio a 64 strati.

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Authors and Affiliations

  1. Servizio di Radiologia, IRCCS Ospedale Pediatrico Giannina Gaslini, Largo Gaslini, 16147, Genova, Italy

    P. Tomà, F. Rizzo, N. Stagnaro, G. Magnano & C. Granata

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  1. P. Tomà
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  2. F. Rizzo
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  3. N. Stagnaro
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  4. G. Magnano
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  5. C. Granata
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Correspondence to C. Granata.

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Tomà, P., Rizzo, F., Stagnaro, N. et al. Multislice CT in congenital bronchopulmonary malformations in children. Radiol med 116, 133–151 (2011). https://doi.org/10.1007/s11547-010-0582-4

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  • DOI: https://doi.org/10.1007/s11547-010-0582-4

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