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Ultrafast CT Scans: Sedation of Young Children Unnecessary.

WASHINGTON -- Ultra fast computed tomography provided high-quality diagnostic imaging of young children without the need for sedation, the results of a pilot study have found.

Ultrafast CT has previously found a niche in imaging the beating heart to quantifying coronary artery calcification, Maj. John D. Statler, MC, USA, noted in his presentation at the annual meeting of the American Roentgen Ray Society.

"We became interested in using it in a similarly fast-moving patient population--the unsedated child," said Dr. Statler, an attending physician in radiology at Walter Reed Army Medical Center, Washington.

With ultrafast CT, an entire adult chest can be scanned in less than half a second. In contrast, standard CT requires that the patient remain still for about 1 minute. This necessitates sedation in most children under age 6 years, he said.

At Dr. Statler's institution, this means that the approximately 600 young children who are assessed by CT each year must be admitted to the pediatric sedation unit, have a history and physical examination there, be transported to and from the scanner by trained personnel, and have a 1- to 2-hour recovery period under observation.

Sedation fails in up to 5% of patients and can cause adverse effects ranging from mild respiratory depression to cardiopulmonary collapse, he noted.

Dr. Statler conducted a pilot study of 20 children aged 3 weeks to 6 years (average age 2 years) in which ultra-fast CT was used to image the head, chest, abdomen, or pelvis. No child required any sedation, and no exams needed to be repeated or rescheduled because the child could not comply.

Three radiologists reviewed the images to quantify the motion effects and to evaluate the image quality. The radiologists used a standard 4-point rating scale that was first described by Dr. S.A. Brody of Buffalo Children's Hospital. In that scale, a score of 1 indicated a perfect image with no motion artifact and a score of 4 indicated a total loss of diagnostic information due to severe motion artifact.

The average score of all 20 scans was 1.2. Scores ranged from 1 to 1.69.

"Perhaps our most telling [result] was that our referring pediatricians began to ask for this CT technique by name," Dr. Statler said.

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Publication:Family Practice News
Geographic Code:1USA
Date:Jul 15, 2000
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