CT evaluation of blunt abdominal trauma in children: comparison of ultrafast and conventional CT

Previous reports describing the use of ultrafast CT have emphasized its value in evaluating the heart, chest, and airway. We describe our experience using this technology on children with blunt abdominal trauma. We retrospectively reviewed 54 consecutive ultrafast CT studies and 30 consecutive conventional dynamic CT studies performed on children after blunt abdominal trauma. Thirty percent of the scans showed abnormalities. CT or pathologic follow-up was available for all abnormal cases. We compared scans made with these two techniques for diagnostic accuracy, amount of visible motion on each slice, and contrast enhancement seen on each study. A protocol of 0.4-sec images and 2 ml/kg IV contrast material administered before scanning was used for the ultrafast CT scans. A standard protocol of 2-sec scanning and 3 ml/kg IV contrast material was used for conventional CT studies. There was no difference in diagnostic accuracy between the two techniques. There was significantly less visible motion (p less than .0001) and significantly better contrast enhancement (p less than .0001) seen on the ultrafast CT studies. Two of 54 ultrafast scans had images with sufficient motion to require repeated scanning, compared with 13 of 30 conventional CT studies. In addition, ultrafast scans required less sedation, decreased radiation dose, and improved accessibility of the patient to support personnel. Ultrafast CT is a valuable technique for abdominal imaging, offering equal diagnostic accuracy with improved image quality and important benefits to the patient.