Cranial CT in Pediatrics
Cranial CT in Pediatric Diagnostics
Introduction
Cranial Computed Tomography (CT) remains a cornerstone in pediatric neuroimaging, offering rapid acquisition and detailed visualization of intracranial structures. Its primary advantage lies in emergency situations and acute neurological conditions.
Key Points
- Rapid acquisition time (crucial for unstable patients)
- Excellent bone detail visualization
- Superior hemorrhage detection
- Widely available in emergency settings
- Requires careful radiation dose consideration
Technical Specifications
Scanner Requirements
- Multi-detector CT (MDCT)
- Minimum 16-slice configuration
- Sub-millimeter resolution capability
- Rapid acquisition protocols
- Dose modulation technology
- Image Parameters
- Slice thickness: 2.5-5mm for routine, 0.625-1.25mm for detailed study
- Pitch factor optimization
- kVp and mAs adjustments by age/size
- Reconstruction algorithms
Imaging Protocols
Standard Protocol Components
- Non-contrast Studies
- Emergency trauma assessment
- Hemorrhage detection
- Hydrocephalus evaluation
- Initial mass assessment
- Contrast-enhanced Studies
- Tumor evaluation
- Infection assessment
- Vascular malformation characterization
- Post-operative monitoring
Clinical Applications
Primary Indications
- Trauma
- Acute head injury assessment
- Skull fracture evaluation
- Intracranial hemorrhage detection
- Mass effect assessment
- Non-traumatic Emergencies
- Acute hydrocephalus
- Shunt malfunction
- Acute stroke
- Intracranial herniation
Pathological Findings
Common Abnormalities
- Traumatic Lesions
- Epidural hematoma
- Subdural hematoma
- Subarachnoid hemorrhage
- Parenchymal contusion
- Diffuse axonal injury
- Non-traumatic Conditions
- Brain tumors
- Hydrocephalus patterns
- Infectious processes
- Congenital malformations
Radiation Considerations
Dose Reduction Strategies
- Technical Factors
- Age-specific protocols
- Weight-based parameters
- Automatic exposure control
- Iterative reconstruction
- Protocol Optimization
- Limited scan range
- Single phase whenever possible
- Appropriate slice thickness
- Focused follow-up studies
Interpretation Guidelines
Systematic Approach
- Bone Window Assessment
- Skull integrity
- Sutural assessment
- Base of skull
- Brain Parenchyma Evaluation
- Density variations
- Mass effect
- Midline shift
- Ventricular system
- Vascular Structures
- Major vessels
- Venous sinuses
- Enhancement patterns
Advanced Applications
Post-processing Techniques
- 3D Reconstructions
- Volume rendering
- Surface rendering
- Multiplanar reformations
- Specialized Studies
- Perfusion imaging
- Dynamic studies
- Dual-energy applications
Quality Control
- Image Quality Parameters
- Motion artifacts assessment
- Contrast timing evaluation
- Reconstruction quality
- Protocol adherence
- Documentation Requirements
- Dose reports
- Technical parameters
- Contrast details
- Post-processing records
