Kidney diseases in children are relatively frequently requiring a constant imaging investigation for detecting progression disease in order to avoid or to delay renal failure.
Pediatric patients are more sensitive than adults to X-ray because this exposure can cause DNA damages and can increase the cancer risk per unit dose.
For these reasons, the reduction dose in children is imperative.
We currently use CT urography (CTU) exams for pediatric patients with distinct protocols respecting ALARA principles (as low as reasonably achievable). However, the individual risk...
Description of activity and work performed
All the children investigated in our department in the last 5 years are explored by ultrasound first, ultrasound being also the follow-up technique. We use ultrasound informations as a base for the following investigations. In the past, we used conventional urography, but the X-ray exposure was significant (especially in old equipment) and the results were frequently inconclusive, sometimes even ambiguous, additional CT exams being necessary for a complete imaging diagnosis, so we have decided to replace this method with CT urography.
Our continuous concern was...
Conclusion and recommendations
Split-bolus CTU technique is a method with high sensitivity and specificity, useful in reducing radiation exposure in children with reno-urinary disease except for tumoral and vascular pathology. The mandatory condition is that children have to be previously investigated by detailed ultrasound exam (including Doppler investigation) in order to perform an appropriate selection for CT scan.
Even if some of the pathological conditions require MRI exams (especially in associated malformative pelvic pathology), CTU remains the best imaging choice in cases with ultrasonographic doubts.
O. Rizea; Bucharest/RO - nothing to disclose A. C. Nicolae; Bucharest/RO - nothing to disclose I. G. Lupescu; Bucharest/RO - nothing to disclose
Dr. Oana Rizea
Prof. Dr.Ioana G.Lupescu
Radiology, Medical Imaging and Interventional Radiology Department
Fundeni Clinical Institute, UMPh Carol Davila, Bucharest, Romania
Skip M. Alderson, MD, Susan Hilton, MD, and Nicholas Papanicolaou, MD- CT urography: Review of technique and spectrum of diseases- Applied Radiology, Jul 12, 2011.
Yong Hee Kim, Myung-Joon Kim, Hyun Joo Shin, Haesung Yoon, Mi-Jung Lee- Simplified split-bolus intravenous contrast injection technique for pediatric abdominal CT, Clinical Imaging, Published: June 14,2017.
Changshu Chen, Jui-Sheng Hsu, T. H. Jaw, Ming-Chen Paul Shih, Lo-Jeh Lee, Tzu-Hsueh Tsai, Gin-Chung Liu-Split-Bolus Portal Venous Phase Dual-Energy CT Urography: Protocol Design, Image Quality, and Dose Reduction- AJR. American journal of...