MDCT angiography safe and effective for imaging children


MDCT angiography is a safe and effective alternative to conventional angiography in imaging pediatric patients suspected of having blocked arteries in the hand, arm, thigh and leg, a new study shows.

The study, the first review of MDCT angiography of the extremities in pediatric patients, appears in the July, 2004 issue of the American Journal of Roentgenology.

The study included six pediatric patients who had been referred for imaging to rule out arterial occlusion and stenosis or for preoperative evaluation before reconstructive surgery, said Dr. Musturay Karcaaltincaba of Hacettepe University School of Medicine in Ankara, Turkey.

"The technical success rate in our study was 83%, but diagnostic information was obtained in all patients," Dr. Karcaaltincaba said. Success was dependent on being able to image the arteries when they were enhanced most by the contrast media, he said. Arteries in children are small and difficult to locate so "we used a modification of the automated bolus tracking," Dr. Karcaaltincaba said. Contrast was injected through a vein into the patient and beginning 10 seconds later stationary images were repeatedly taken near the area of the proximal artery; these images appeared on a screen. The radiologist watched the screen and as soon as the contrast media enhanced the lumen of the artery, the radiologist began sequential scanning to capture images as the contrast media flowed through.

Conventional angiography has several disadvantages, including a long procedure time and the need for sedation. A arterial catheter is inserted into the patient, and complications can occur, said Dr. Karcaaltincaba. MDCT angiography, on the other hand, is faster; there is no need for sedation; it requires a low volume of contrast material and it is noninvasive. "We recommend that pediatric radiologists consider noninvasive vascular imaging tests, such as MDCT angiography, before performing conventional angiography in pediatric patients to avoid complications," he said.

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Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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