There is a wide range of diseases involving paediatric respiratory system which arises from lung parenchyma, mediastinum, pleural and chest wall. Imaging plays as an adjunct and important component in the management of patients. Modalities involved in imaging of paediatric chest include chest radiograph, ultrasound, fluoroscopy/angiography, nuclear medicine, CT scan and MRI.
However, before we even perform an imaging on paediatric patients, there is an important aspect of imaging that need to be highlighted, radiation awareness among clinicians. Whenever we want to consider a choice of imaging especially CT scan, radiation dose should be our concern and if it is needed then it must be justified. CT scan is one of the highest radiation dose when performed. Why are we more concern on radiation dose in children versus adults? i) Children are considerably more radiosensitive than adults, as demonstrated in epidemiologic studies of exposed populations. ii) Children also have a longer life expectancy than adults, resulting in a larger window of opportunity for expressing radiation damage. iii) Children receive a higher dose than necessary when adult imaging protocol are used for children.
In this lecture we will highlight the role of CT in assessment of thoracic abnormality in children. Case base approach will be discussed in highlighting the clinical application of CT Thorax. The case presentation will be based on 3 main compartments in the chest i.e.; lung parenchyma, airway and mediastinum. The advantage and disadvantage of CT scan will also be discussed.
In conclusion, imaging plays as an adjunct and important component in the management of paediatric patient with thoracic diseases. CT scan is currently the main imaging modality for assessment thorax particularly the lung parenchyma. Choice of imaging is important in order to get the correct diagnosis and weighing between risk and benefit of radiation dose is mandatory especially on decision of using CT scan in children. Regular discussion between Paediatrician/Clinician and Radiologist and good teamwork are important to make sure our paediatric patients are getting the best imaging, the best diagnosis and treatment.