Die Computertomographie bei der Bildgebung von Kindern mit kongenitalen Herzvitien

Zusammenfassung: Kongenitale Herzfehler sind die häufigsten kongenitalen Fehlbildungen. Echokardiographie und Katheterangiographie gelten allgemein als Goldstandard zur Abklärung angeborener Herzerkrankungen. Die Magnetresonanztomographie ist aufgrund ihrer Fähigkeit, Herzvitien morphologisch und funktionell zu charakterisieren, als ein wichtiges ergänzendes Verfahren anzusehen. Durch mehr und mehr dosissparende Untersuchungsprotokolle der neuesten Gerätegenerationen und eine gleichzeitig bessere zeitliche und räumliche Auflösung findet die Computertomographie zunehmend Eingang in die Abklärung kongenitaler Herzfehler. In der präoperativen Planung und der postoperativen Kontrolle erlaubt sie eine übersichtliche Darstellung komplexer Fehlbildung nicht nur des Herzens, sondern auch der pulmonalvenösen und -arteriellen Zirkulation sowie des systemischen Kreislaufs. Dieser Beitrag gibt eine Übersicht über die technischen Aspekte der kardialen CT und die Anpassung des Untersuchungsprotokolls an die zu erwartende Pathologie und das Alter des Kindes. Zudem werden die Möglichkeiten und Limitationen der unterschiedlichen dosissparenden Protokolle erläuter

Die Computertomographie bei der Bildgebung von Kindern mit kongenitalen Herzvitien

Congenital heart diseases are the most common congenital abnormalities of development. In general, echocardiography and cardiac catheter angiography are considered the gold standard for the evaluation of congenital heart disease. Cardiac magnetic resonance imaging has become an important supplementary imaging modality because of its ability to provide an accurate morphological and functional evaluation. The role of cardiac computed tomography in the imaging of patients with congenital heart disease is becoming increasingly more important due to the development of low radiation dose protocols and improvements in the spatial and temporal resolution. In the preoperative depiction and follow-up after surgical repair of congenital heart diseases, cardiac computed tomography provides detailed information of the heart, the venous and arterial pulmonary circulation as well as systemic arteries. This article reviews the technical aspects of cardiac CT and the modification of examination protocols according to the expected pathology and patient age. The potentials and limitations of the various radiation dose reduction strategies are outlined

Thoracic imaging of coronavirus disease 2019 (COVID-19) in children: a series of 91 cases

Background: Pulmonary infection with SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2; COVID-19) has rapidly spread worldwide to become a global pandemic. Objective: To collect paediatric COVID-19 cases worldwide and to summarize both clinical and imaging findings in children who tested positive on polymerase chain reaction testing for SARS-CoV-2. Materials and methods: Data were collected by completion of a standardised case report form submitted to the office of the European Society of Paediatric Radiology from March 12 to April 8, 2020. Chest imaging findings in children younger than 18 years old who tested positive on polymerase chain reaction testing for SARS-CoV-2 were included. Representative imaging studies were evaluated by multiple senior paediatric radiologists from this group with expertise in paediatric chest imaging. Results: Ninety-one children were included (49 males; median age: 6.1 years, interquartile range: 1.0 to 13.0 years, range: 9 days–17 years). Most had mild symptoms, mostly fever and cough, and one-third had coexisting medical conditions. Eleven percent of children presented with severe symptoms and required intensive unit care. Chest radiographs were available in 89% of patients and 10% of them were normal. Abnormal chest radiographs showed mainly perihilar bronchial wall thickening (58%) and/or airspace consolidation (35%). Computed tomography (CT) scans were available in 26% of cases, with the most common abnormality being ground glass opacities (88%) and/or airspace consolidation (58%). Tree in bud opacities were seen in 6 of 24 CTs (25%). Lung ultrasound and chest magnetic resonance imaging were rarely utilized. Conclusion: It seems unnecessary to perform chest imaging in children to diagnose COVID-19. Chest radiography can be used in symptomatic children to assess airway infection or pneumonia. CT should be reserved for when there is clinical concern to assess for possible complications, especially in children with coexisting medical conditions. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature