Pediatric CT Imaging Guideline
Original Date: 06/2016 | Supersedes: 06/2016, 09/2021 | Last Review Date: 03/2024
Purpose: The use of CT in children has increased over the past 2 decades (Mighoretti et al. . 2013). With the increase in CT exposure the risk of cancer has increased. It is estimate as high as 1/500 (Hoscher et al., 2013). Hoscher et al report Chest x-ray imaging and chest CT imaging provided good correlation of information. However, CT chest did not change patient management but rather significantly increased patient radiation exposure. (8.7±1.1mSv versus 0.017 ± 0.002mSv, P , 0.001) (p.352). To minimize the risk of radiation exposure in the pediatric trauma patient the following imaging guideline was adapted from Denver Health and Children’s Hospital of Los Angeles.
Abdominal Trauma
Pediatric Thoracic Trauma
*** Suspected Thoracic spinal cord injury = CT Chest
***Change in patient status: Re-evaluate and consider additional imaging
Adapted from Golden et al. (2016) Children’s Hospital Los Angeles
References
Golden J, Isani M, Bowling J, Zagory J, Goodhue CJ, Burke RV, Upperman JS, Gayer CP. (2016). Limiting chest computed tomography in the evaluation of pediatric thoracic trauma. Journal of Trauma and Acute Care Surgery, Publish Ahead of Print. Doi: 10.1097/ta.0000000000001110.
Holscher, C., Faulk, L., Moore, E., Burlew, C., Moore, H., Stewart, C, Bensard, D. (2013). Chest computed tomography imaging for blunt pediatric trauma: not worth the radiation risk. Journal of Surgical Research, 184, 352-357. http://dx.doi.org/10.1016/j.jss.2013.04.044
Mighoretti, D., Johnson, E., Williams, A., Greenlee, R., Weinmann, S. Solberg., L., Smith-Bindman, R. (2013). The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. American Medical Association Pediatrics, 167(8), 700-707. doi: 10.101/jamapediatrics.2013.311