Technique and clinical applications of full-inflation and end-exhalation controlled-ventilation chest CT in infants and young children.
BACKGROUND
The inability of young children to cooperate with breath holding limits the usefulness of chest CT.


OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Long
F R
FR
Children's Radiological Institute, Children's Hospital Columbus, OH, 43205-2696, USA. Flong@chi.osu.edu
Castile
R G
RG
D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012119:Respiration; D014057:Tomography, X-Ray Computed / Q000379:methods*