Computed tomography for children to do. CT scan for children (computed tomography). CT and MRI under anesthesia

Children are assigned to children of any age in the presence of serious indications. Usually, in all sources of information about how CT is performed, it is said that examination of children under 12 years of age is prohibited. However, such surveys can be performed for health reasons, when the potential benefit of the information received outweighs the harm from the study.

At what age is computed tomography performed on children

In Russia, exact statistics on how many children undergo CT scans are not kept, so here we will present the figures and facts that were established by American researchers. According to research data, for every 1000 examinations, about 40 are in small patients. Moreover, out of these 40 examinations, 20 are conducted for children under the age of 5.

In Russia, computed tomography is prescribed for children of any age, including infants. The decision on the possibility and admissibility of such an examination is made by the radiologist, depending on the condition of the child and the pathology he has.

How does x-ray radiation affect the child's body

A feature of the child's body is that active growth is ensured by active cell division. Cells that actively and rapidly divide are very vulnerable to any damaging factors, including the action of X-rays. In this regard, the sensitivity of the child's body to the harmful effects of X-rays is 5 times higher than that of adults.

Studies by American scientists have made it possible to calculate in what percentage of cases an oncological disease induced by X-rays can develop. It can be said right away that the risk of getting sick is low: for four million children who have been exposed to X-rays (that's how many children in the States undergo CT scans during the year), only about 5 thousand have a risk of developing a cancerous tumor or leukemia during their lifetime due to received radiation dose.

These figures could not be taken into account at all when going with your child for an examination. But American doctors believe that:

1. in almost half of the cases, children are exposed to an unjustified risk, since the CT examination performed could well be replaced by any other examination method that is safe for the body;
2. in a certain percentage of cases, children received a higher dose of radiation than was necessary to obtain images due to the fact that the settings of the tomograph are the same for children and adults.

So what to do?

Children are sick. And often the symptoms are such that it is difficult for a doctor to make a correct diagnosis without conducting examinations. In such cases, you can proceed as follows:

1. before conducting a CT scan, it is necessary to use any other less informative, but safe for the child, examination methods, such as ultrasound, MRI, ECG, FGDS, etc. (in most cases, these methods provide the information necessary for making a diagnosis);
2. CT is never performed as the first and only method of diagnosing a suspected disease, nor is it performed "just in case" or "to make sure everything is in order";
3. for the examination, it is better to give preference to MSCT (multispiral computed tomography), since the radiation dose of such a tomograph for a patient is two times less than that of a spiral one;
4. it is best to conduct an examination aimingly: the smaller the area under study, the less harm will be for the child's body;
5. before conducting the examination, it is necessary to find out what settings of the apparatus are set by the staff: special settings are set for children, since half the dose of radiation, or even less, is enough to “shine” a child’s small body in volume and weight.

According to American researchers, in about 60% of cases, the risk for a child is not justifiably high, since the indications for CT are not serious enough and / or it is possible to obtain the same information using other methods. In another 25% of cases, the harmful effects of X-rays can be reduced by choosing the right radiation parameters, sufficient to obtain clear and informative images of the child's body.

Computed tomography (CT) is one of the most informative methods for studying the brain. Its use allows obtaining a high-quality image of the brain. CT scan of the child's brain simplifies the diagnosis of complex and severe diseases. Sensitivity to radiation in children is several times higher than in adults. However, if there are indications, the use of this diagnostic method allows you to identify serious diseases and pathologies at an early stage. Therefore, the study is prescribed only if the benefits of the study outweigh the possible harm.

Computed tomography of a child's brain is different from a similar procedure for an adult. At the age of three years, children are characterized by high mobility. It is very difficult to force the baby to be immobile for a long time: it is impossible to hold him for scanning. Newborn babies may also need the procedure. Therefore, in both cases, the study is performed under general anesthesia.

But general anesthesia and radiation are dangerous for a child. Therefore, testing is recommended only when there is no other way to get a diagnosis. MRI is performed on the basis of electromagnetic radiation, so harmful x-rays are not used. However, such a study is not always able to show the pathologies and diseases of the brain that are visible on CT. When prescribing a study, the benefits of diagnosing a disease should be many times greater than the harm from it. But do not forget that late diagnosis of serious diseases is often even more dangerous than x-rays or harm from the necessary general anesthesia.

At what age is CT allowed?

Computed tomography is prescribed for children of any age. The study can be assigned even to a newborn with absolute indications for conducting this particular research method. For example, if MRI and other research methods turned out to be uninformative. Up to a year, neurosonography is most often used to diagnose diseases and pathologies of the brain. This is an ultrasound of the brain, carried out due to the presence of an open fontanelle.

After the closure of the fontanel, neurosonography is no longer informative, so CT is needed.

CT is prescribed for children to detect neoplasms and the consequences of injuries, so the importance of early diagnosis cannot be overestimated. There is no particular difference in the conduct of the study of newborns, as well as children under the age of three and after three years. However, for small children, the procedure is performed under general anesthesia due to the need to be immobile for a long time.

Indications

CT of the head is prescribed for young children to identify the following pathologies:

• Birth trauma in newborns. Using this research method, it is possible to diagnose a depressed skull fracture, a fracture of the skull at the seams of the bones, or intracranial hemorrhage.
• Injuries received by children from the age of one and a half years, when falling or hitting. With the help of CT, it is possible to diagnose the degree of injury, the presence of a hematoma, as well as fractures of the skull bones. Computed tomography is the most informative method for diagnosing the degree of bone damage.
• Increased intracranial pressure.
• Causes of mental disorders. Even at an early stage, with the help of CT, it is possible to make an accurate diagnosis.
• Tumors and cysts.
• Vascular anomalies and aneurysms.
• Lesions of the musculoskeletal system.
• Malignant neoplasms in the brain.
• Various anomalies in the development of the respiratory system.

CT is a more dangerous research method, therefore, it is prescribed only if there are contraindications to MRI, or this method is not informative.

Contraindications and restrictions in children

Computed tomography of the brain for children is prescribed at any age. However, there are a number of contraindications to the use of this research method. These include:

• Allergic reaction to a contrast agent, such as iodine.
• Renal failure.
• Mental deviations in the expressed form.
• Metal implants, staples or clips in the body.

Preparation for the examination

Newborns and young children are examined under general anesthesia. Therefore, the preparation includes a consultation with an anesthesiologist recommending the preceding steps to anesthesia. Older children do not need anesthesia. The main requirement for obtaining high-quality images is the immobility of the patient for a long time. Study preparation includes:

1. Refusal of food at least 4 hours before the study. If the stomach is full, the risk of suffocation by vomiting increases. Newborns should be given food 3 hours before the procedure. Drinking liquids before CT is also prohibited.
2. Moral preparation of the child. If the procedure is performed on an older child who is going to be in the process of research in the mind, then it is necessary to mentally prepare him. The child needs to be explained that the study is completely painless. He needs to be motionless for a long time, and if this rule is violated, he will have to start all over again.
3. Use of nasal drops. During the examination, the child must have good nasal breathing. In the presence of a runny nose or swelling of the nasal passages, it is recommended to drip vasoconstrictor drops.
4. Analyzes. Before the CT scan, you need to take tests. Some clinics require only a certificate from a pediatrician, while others require ECG results, general blood tests, urine tests, and other tests.
5. Allergy analysis. Sometimes a CT scan with contrast is recommended. In this case, allergy tests for a contrast agent are prescribed before the procedure. This analysis is mandatory for children prone to allergies.

How is research going

To obtain accurate results of the study, it is necessary to be in a stationary position throughout the scan. Therefore, newborns and young children are given general anesthesia. To determine the exact dosage of anesthesia, the child is weighed.

If you want to take pictures of the vessels of the brain, a contrast agent is first introduced. This drug, most often made on the basis of iodine, is injected into a vein.

The patient is placed on the table in the correct position, a stand is placed under the head. The head is fixed with straps. After that, the patient on the table is pushed into the apparatus. After that, those present must leave the room, and the scan starts. The patient must remain still during the procedure. The results of the study will be ready 30-40 minutes after the scan.

To understand what CT is, it is necessary to understand what the results of the study look like. With the help of computed tomography, it is possible to study the relationship between clinical and morphological expressions after injuries. And also this research method allows predicting disorders that can occur as a result of pathologies of certain parts of the brain. Based on the images, the doctor can prescribe the appropriate treatment or rehabilitation program for each child.

CT scans can be normal, or they can indicate pathologies and diseases of the brain. Photo changes include:

• Clarity of the boundaries of the ventricles, bones and cerebral cortex, as well as trauma or pathological damage.
• Changes in nerve fibers due to various diseases or injuries.
• The presence of neoplasms that displace the ventricles of the brain.
• The presence of a foreign body after trauma.
• Changes in blood vessels and nerve fibers due to various injuries, diseases and congenital pathologies.
• The accumulation of fluid in the tissues of the brain, arising from trauma, hemorrhage, or pathological change.

Timely diagnosis allows you to make a diagnosis and start treatment. If you follow the recommendations of a specialist, it will be possible to detect the problem at the initial stage.

When deciphering the results, the doctor is guided by certain indicators. Normal picture:

• The ventricles have clear contours.
• Clear boundaries of bones and bark.
• The ventricles are not displaced.
• The absence of anomalies in the vessels and nerve fibers.
• There are no signs of hemorrhage and accumulation of fluid.

The presence of pathology:

• Fuzzy contours of the cerebral ventricles are observed.
• Blurred boundaries of the cerebral cortex. Such a pathology may be a symptom of the presence of a large formation.
• Characteristic signs of fluid accumulation.
• Damage to nerve fibers.
• Narrowing or dilation of blood vessels.
• Bone damage due to trauma.

CT is an accurate and informative method for diagnosing diseases and pathologies of the brain. Allows you to identify the presence of malignant tumors, pathologies of cerebral vessels, injuries and other injuries. Timely conduct of the study will avoid the occurrence of serious complications.

Currently, one of the most informative medical research is. This method allows you to examine any organs or areas of the body and obtain high-quality images of several sections. Especially valuable is the possibility of such a study for diagnosing diseases in children at an early stage. However, there are a number of features of a CT scan for a baby that should be considered when agreeing to the procedure.

Specificity of early age

MRI diagnostician

Head of the department, doctor of medical sciences.

Everyone knows that children, due to their age needs, are very mobile, which makes it difficult to study, which can only be carried out when the patient is completely at rest inside the apparatus. Therefore, doctors often have to resort to general anesthesia for the duration of the procedure. Doctors say that such anesthesia will not cause harm to health. However, you need to be sure that the child does not have allergies.

In addition, it is important to take into account the fact that the sensitivity of children to radiation is five times higher than that of adults, so computed tomography for children should be justified. Of course, this applies more to countries where such a procedure does not require special clarifications and approvals.

In Russia, once again such a study will not be appointed, since the number of installations is not so large, there is often a queue for this procedure. Nevertheless, this fact should be taken into account with us. However, one must understand that there are situations when not doing CT is more harmful than doing it. After all, late identification of the problem can make treatment impossible.

Indications

As a rule, computed tomography of children is performed to diagnose brain diseases. Case indications may include:

1. Injuries;
2. Signs of increased intracranial pressure;
3. Tumors are suspected to be benign or malignant;
4. Suspicion of hemorrhage;
5. Signs of a mental disorder.

CT scans for children may be performed to examine other organs and tissues of the body, for example:

• eye;
• inner ear;
• sinuses;
• blood vessels;
• sections of the spine;
• hearts;
• liver;
• kidneys;
• pancreas;
• pelvic organs;
• skeleton.

Contraindications

When conducting a study, it is important to consider possible contraindications:

1. Allergy to iodine, if necessary, the introduction of contrast;
2. Claustrophobia;
3. The presence of metal structures.

Diagnostic procedure

Before conducting a CT scan, the body should be prepared. You should not feed the child later than 4 hours before the study. During the procedure, the patient is placed on the diagnostic table. If necessary, general anesthesia is given.

Next, the limbs and head are fixed with straps. Then the table slides directly into the device itself, scanning is carried out. If a pathology is detected, the patient is injected intravenously to determine the clear contours of the tumor, vascular anomalies, etc.

Is it possible to do CT scans for children under one year old?

Leading pediatric neurologists specializing in diseases of the brain give an unequivocal answer to the question posed: it is possible to do CT scans for children under one year old, if there are absolute indications for this. In the first months of life in infants, the main method for examining the brain is ultrasound. As a rule, it has a fairly high information content. As soon as the fontanelles close, ultrasound, as a method of analysis, becomes inaccessible, and it is replaced by computed tomography. With regard to studying the state of other organs of the smallest patients, CT is the most informative. There is no sharp line between questions: is it possible to do CT scans for children of two, three, five or one year old?

In the absence of allergic reactions (the doctor is convinced of this before the start of the procedure) and elements of metal structures in the body, CT scans can be performed for children under 12 months of age.

Information for analysis: in most cases, a CT scan of the brain in children is performed after falls (with an existing blow to the head), as well as suspicion of the presence of tumors. Even if we take it for granted that there is little harm from radiation, the benefits of a timely detected hematoma or tumor are incomparably greater.

Pros and cons

In the Hippocratic oath, the thought “do no harm” runs like a red thread, so any doctor, understanding all the possible risks of the procedure, is unlikely to prescribe it without unnecessary need. Therefore, when deciding whether to agree or disagree with such a study for your child, you must first take into account the fact that you trust your doctor. If there is trust, then there is no doubt about the need for such a procedure.

It is important to understand that the lack of high-quality diagnostic information at the right time in the presence of suspicions regarding a particular disease, in the early stages, can often be critical for timely treatment.

The sooner this or that pathology is detected, the more likely it is to defeat the disease. If you conduct a survey of all those who did CT scans for children, then there is hardly a person whom he regretted. If the problem was found, this made it possible to start treatment in a timely manner, and if everything worked out, then at least there was no longer any need to live in doubt. So feel free to make a decision.

Where can I do a CT scan for children in Moscow

The CT scan procedure for children in Moscow can be carried out in a state clinic, but institutions equipped with a tomograph are sorely lacking. This creates queues, and a long wait for research in a number of serious conditions is an unaffordable luxury. If the procedure needs to be carried out quickly, certified private clinics come to the rescue. On our website you can find a list of the best diagnostic centers that perform CT scans for children (section "Clinics").

It is important to know:

1. The dose of anesthesia is calculated very strictly, based on the measurement of the weight of the child and taking into account his age;
2. Mom can be with the baby from the moment of anesthesia until the end of the procedure;
3. You can take your favorite toys and other attributes with you;
4. doctors performing CT scans for children are the highest professionals, since the responsibility for the procedure and the results of the procedure lies with them.

Experts advise: when studying the question: where can a child have a CT scan, be sure to read the rules of a particular clinic and analyze the reviews of its clients on the Internet.

To date, magnetic resonance imaging is perhaps the safest, most modern and reliable research method. It is successfully used for diagnostics in all areas of medicine, for many well-known diseases. But when children get sick, parents are justifiably worried.

Is this procedure safe for a child? At what age do children get an MRI? If you have a one-year-old baby, is it possible to use the resonance method? If your child is 3 years old, 5 years old or 7 years old - how will he endure the study, will it affect his well-being? You will find answers to all these questions in this article.

In fact, it is impossible to mention in one article all the cases in which tomography is prescribed for children. This study is considered safer than traditional radiography (does not imply radiation exposure to a small patient). Therefore, sometimes the doctor may recommend the procedure immediately, without prior diagnosis on the X-ray. This is especially true for very young children under 3 years of age or in case of a serious pathology.

In addition, MRI is a more informative method than ultrasound and X-ray diagnostics. And usually such an examination is carried out after the initial diagnosis by the above methods. For example, tomography of brain tissue is always prescribed after a preliminary diagnosis is made on ultrasound as a clarifying study.

We list the five main diseases in which MRI is indicated for a child:

• trauma, including the slightest suspicion of a concussion, is a reason to perform an MRI of the child’s head;
• deviations in the results of screening ultrasound of the heart, hip joint, brain;
• suspected tumor;
• foreign bodies in the digestive tract and respiratory tract;
• infectious diseases and much more.

Contraindications for the study

Since the range of diagnostic procedures for children is noticeably narrowed due to specific features, we can say that there are no contraindications for MRI. Indeed, the method is safe, non-invasive and fairly affordable.

Small children under 5-7 years of age have to perform the study under general anesthesia, because. During the procedure, the patient is required to remain completely still. If your offspring does not tolerate anesthesia well or suffers from an allergic reaction, you need to discuss these contraindications with your doctor, and weigh the medical risks.

Preparing a child for research

In general, the magnetic resonance diagnostic method does not imply thorough preparation. The main thing for the child and parents is to calm down before the study. The child needs to be set up to remain still, explain that the procedure is painless and relatives will be there all the time.

Although in general preparation is not required, there are a number of nuances that the doctor can warn about before the study. For example, if a child is under five years old and he will have general anesthesia, then tomography is performed strictly on an empty stomach. In other cases, a special diet, as a rule, is not prescribed.

What to expect during the procedure?

Before the start of the study, the parents of the child are asked about his illness, well-being and the presence of allergic reactions. After that, a contrast agent is administered intravenously if necessary.

If the patient is under three years of age or for other reasons the child needs anesthesia, an anesthesiologist is invited, who is obliged to be nearby all the time of the study and control breathing, pulse and other vital functions.

A small patient is placed on a special table, fixed with straps. During a tomography of the brain, a child will be put on a device with sensors that record nerve impulses. This will help reduce the fear of an unknown procedure.

During the study, the table of a magnetic tomograph is progressively placed inside an apparatus that resembles a hollow pipe. In order not to irritate patients with the sounds of a tomograph, they are put on earplugs or headphones. Typically, the study takes no more than an hour or up to an hour and a half with the introduction of contrast.

What can parents do to make the process easier?

• The introduction of a contrast agent resembles a regular injection or taking blood from a vein, you need to explain to the baby that it does not hurt.
• It is important to maintain contact with the child, to distract him before and during the study.
• In modern tomographs, there are screens for watching cartoons: if the child is distracted and relaxed, this will help in accurate diagnosis in the best possible way. If the study does not involve general anesthesia, parents should opt for such a modern device.
• It is extremely important to explain to the child, if possible, that he must remain still! Otherwise, you will have to redo everything anew, and the procedure will be delayed.

What will magnetic resonance imaging of the head show?

Children are most often prescribed an MRI of the head. This is due, firstly, to the fact that the method is best suited for nervous tissue with an active metabolism. In addition, today doctors try not to prescribe X-ray examinations for young children due to the effect of dangerous ionizing radiation on actively dividing cells. Magnetic resonance comes to the rescue.

Here are just some of the pathologies that this research method can detect:

• congenital malformations of the brain;
• brain cyst;
• hydrocephalus;
• trauma and concussion of the brain;
• cranial nerve pathologies: facial, ocular, auditory (congenital, traumatological, infectious);
• meningitis and meningoencephalitis;
• hormonal disorders - pituitary tumors;
• organic diseases of the cerebral cortex (epilepsy) and other structures of nerve cells (multiple sclerosis), etc.

Parents should understand that most of the studies conducted on children do not diagnose any terrible brain disorders. But a timely MRI scan of the head can help those children who really need help, and even save them.

This disease is most often observed in very young children. The cyst, as a rule, is not dangerous, however, when it increases, it creates increased pressure on neighboring areas of the brain, which can have a negative impact on the growth and development of the child.

Conclusion

At the moment, there are no alternatives to magnetic resonance imaging in pediatric practice. This method is distinguished by safety, painlessness, accuracy and availability. All diseases must be diagnosed and treated at a very early stage, and a tomograph is a great help in this. The authors of the article sincerely wish you and your children never get sick!

Computed tomography or CT is a non-invasive method for examining internal organs, which is a modern kind of radiological diagnostics. The combination of high-precision X-ray units and powerful computers makes it possible to achieve high quality images and the possibility of creating three-dimensional structures from layered sections.

As a rule, this study is used in adulthood. However, there are situations when CT is also indicated for children. Is CT scan harmful for children? Modern tomographs do not lead to a serious radiation exposure to the child, however, ionizing radiation is still present. If indications and contraindications are not observed, as well as a violation of the technique of the procedure, CT can lead to negative consequences.

What is computed tomography and how does a tomograph work?

CT is a type of conventional x-ray examination, carried out using a special device (tomograph) that creates x-rays and detectors that are connected to a computer.

Passing through the body of a child, X-rays are delayed by the structures of the body to varying degrees. Due to this effect, bone formations appear lighter in the images, and soft tissues, for example, are almost invisible. Special programs installed on a computer process the received data and form a series of images from them: in the form of layered sections and in the form of a three-dimensional structure of organs.

A CT scanner consists of two parts: a table for the patient and a housing containing the emitter and radiation detectors. During the procedure, the child is placed on a table, which is rolled through a hole in the body, which allows you to get x-rays.

Indications and contraindications for the study

CT is used to detect a wide range of diseases. At what age can a CT scan be performed on children? This type of examination is carried out at any age, even after birth. But for this, the child must have clear indications for the use of CT, since the method poses a certain biological risk for the developing baby. The following indications are distinguished:

• The main indication for the appointment of an examination in newborns is the identification of birth injuries, which may be combined with suspicions of fractures of the bones of the head or limbs. Also, CT is the method of choice for diagnosing traumatic brain injuries that can develop in a baby at any age.
• At an older age, computed tomography is performed for children with suspected craniocerebral injuries, hematomas, and fractures of the bones of the base or vault of the skull. It is CT that is best suited to detect violations of the integrity of bone formations.
• Suspicions of anomalies in the development of blood vessels (pathological tortuosity, aneurysms, etc.), benign and malignant formations, and cysts in the central nervous system.
• Computed tomography can be used to detect damage to the chest, nose, nasopharynx, lungs, kidneys, and abdomen in children. In difficult diagnostic situations, CT is used to detect and determine the severity of adenoids in a child.

The main contraindication to the examination is allergy or individual intolerance to drugs for anesthesia. At an early age, the procedure is often accompanied by general anesthesia due to the need for the child to remain still during the examination.

Preparing a child for CT

The safety of the examination and its effectiveness mainly depend on the observance of the rules for preparing the child for the examination. However, there are no specific recommendations. However, if the child is less than 5-6 years old, then computed tomography should be combined with general anesthesia, since children of this age cannot lie still for a long time. In this regard, recommendations for preparation mainly relate to this age group:

• The last meal should take place no earlier than 4 hours before the examination. The presence of food masses in the stomach significantly increases the risk of food regurgitation into the esophagus and aspiration pneumonia. If the baby is less than a year old, then he can be fed 2-2.5 hours before CT. Similar requirements apply to drinking.
• If the child is already over 4 years old, then it is necessary to carefully talk with him before the examination and explain everything that awaits him during the procedure itself. It is important to note that mom or dad will be next to the baby during the CT scan.
• Each child should undergo a clinical examination and consultation with a pediatrician before performing a CT scan to identify indications for the procedure.
• If the study will be carried out with the use of contrast agents, then it is necessary to first put an allergy test.

CT in children: features of the conduct

The main feature of the procedure in childhood is the need for general anesthesia, which, most often, is inhalation in nature. General anesthesia should always be administered by an experienced anesthesiologist who remains by the patient's side throughout the examination.

If a CT scan is performed on a newborn, then it should be swaddled. Older children should be dressed in comfortable clothing.

During the procedure, the baby is fixed on the table of the device, and those parts of the body that are not subject to examination are covered with special lead aprons that do not transmit ionizing radiation. This avoids unnecessary irradiation of the growing organism.

Is computed tomography harmful to a child? There is no single answer. A correctly performed single CT scan will not have any negative impact on the baby's body. However, in case of violation of the examination technique or excessively frequent procedures, ionizing radiation can lead to genetic and somatic changes.

Anton Yatsenko, pediatrician, specially for the site