[What is the value of the whole body spiral CT in the primary radiological imaging of severely injured children?].
OBJECTIVE
Whole body spiral CT scans have become a routine method in the radiological imaging of severely injured patients in emergency rooms of an increasing number of hospitals. The routine use of CT scans is, however, still discussed controversially, especially with regard to its use in children. This is mainly due to the reportedly higher level of exposure to radiation of CT scans as compared to plain radiographs. The aim of the present study was to compare the dose of exposure to radiation of a whole body CT scan to that of a plain radiograph protocol in an animal model for severely injured children.


METHODS
We chose 3 female pigs of different weights to serve as a model for children at different ages. 4 film radiation dosimeters (positioned on the eye, under the breast, paravertebrally on the thoracic spine and in the small pelvis, respectively) were implanted into every pig for each examination. Plain radiographs of the chest and the pelvis in one plane and of the skull and the complete spine in two planes were performed. The CT scan included skull, cervical spine and the whole body from the thorax to pelvis.


RESULTS
The radiation dose of CT scans was 7 times higher as compared to the X-ray protocol, but the performance of CT scans was faster (8 vs. 18 min). The radiation dose of the whole body CT scan was at about 15 mSv.


CONCLUSIONS
Based on our data and a review of the literature we will use whole body spiral CT scans as the preferred method in the primary radiological imaging of severely injured patients. In our opinion, the evident benefit of a reduced time of imaging in combination with superior image information outweighs the higher level of exposure to radiation.
Strohm
P C
PC
Department für Orthopädie und Traumatologie, Klinikum der Albert-Ludwigs-Universität Freiburg. peter.strohm@uniklinik-freiburg.de
Uhl
M
M
Hauschild
O
O
Stankovic
Z
Z
Reising
K J
KJ
Lesniak
M
M
Südkamp
N P
NP
D000818:Animals; D002648:Child; D005373:Film Dosimetry; D006801:Humans; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D011859:Radiography / Q000009:adverse effects; D013552:Swine; D036542:Tomography, Spiral Computed / Q000009:adverse effects*; D051598:Whole Body Imaging / Q000009:adverse effects*