CT in pediatric trauma patients

Abstract

Background

The decision as to whether to perform a computed tomography (CT) examination in severe pediatric trauma poses a challenge. The therapeutic benefit of computed tomography in injured children is lower compared to adults, while the potential negative effects of ionizing radiation may be higher. Thus, the threshold for CT should be higher. Centers that less frequently treat pediatric cases tend to conduct more whole-body CT examinations than dedicated pediatric trauma centers, indicating a clinical overestimation of injury severity with subsequently unnecessary imaging due to inexperience. On the other hand, a CT scan that is not performed but is actually necessary can also have negative consequences if an injury is detected with a delay. An injured child presents a challenging situation for all involved healthcare providers, and thus requires a structured approach to decision-making.

Methods

Selective literature review of the benefits and risks of CT in injured children, as well as indications for whole-body and region-specific CT imaging.

Results and Conclusion

This article provides an overview of current guidelines, recent insight into radiation protection and the benefits of CT in injured children, and evidence-based decision criteria for choosing the appropriate modality based on the mechanism of injury and the affected body region.

Key Points

• Whole-body CT has less of an influence on treatment decisions and mortality in severely injured children than in adults.

• For radiation protection reasons, the indication should be determined more conservatively in children than in adult trauma patients.

• The indication for CT should ideally be determined separately for each region of the body.

• Ultrasound and MRI are a good alternative for the primary diagnostic workup in many situations.

Citation Format

• Appelhaus S, Schönberg SO, Weis M. CT in pediatric trauma patients. Rofo 2025; DOI 10.1055/a-2341-7559

Keywords

children, injuries - infants, injuries - CT - trauma

Publication History

Received: 10 January 2024

Accepted after revision: 05 May 2024

Article published online:
29 July 2024

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