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Korean J Radiol.  2019 Jan;20(1):50-57. 10.3348/kjr.2018.0325.

Four-Dimensional Thoracic CT in Free-Breathing Children

Affiliations
  • 1Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ghw68@hanmail.net

Abstract

In pediatric thoracic CT, respiratory motion is generally treated as a motion artifact degrading the image quality. Conversely, respiratory motion in the thorax can be used to answer important clinical questions, that cannot be assessed adequately via conventional static thoracic CT, by utilizing four-dimensional (4D) CT. However, clinical experiences of 4D thoracic CT are quite limited. In order to use 4D thoracic CT properly, imagers should understand imaging techniques, radiation dose optimization methods, and normal as well as typical abnormal imaging appearances. In this article, the imaging techniques of pediatric thoracic 4D CT are reviewed with an emphasis on radiation dose. In addition, several clinical applications of pediatric 4D thoracic CT are addressed in various thoracic functional abnormalities, including upper airway obstruction, tracheobronchomalacia, pulmonary air trapping, abnormal diaphragmatic motion, and tumor invasion. One may further explore the clinical usefulness of 4D thoracic CT in free-breathing children, which can enrich one's clinical practice.

Keyword

4D CT; CT imaging techniques; Chest CT; Child; Airway; Tracheobronchomalacia; Air trapping; Lung densitometry; Diaphragm motion; Tumor invasion

MeSH Terms

Airway Obstruction
Artifacts
Child*
Four-Dimensional Computed Tomography
Humans
Thorax
Tomography, X-Ray Computed
Tracheobronchomalacia
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