Contrast-enhanced computed tomography with suppression of the precontrast phase in evaluating abdominal neoplasms in children / Aspectos tÃcnicos de tomografias computadorizadas com contraste na avaliaÃÃo de neoplasias abdominais da infÃncia

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

Introduction- The increasing use of computed tomography (CT) among children has given rise to concern about the potential adverse effects of radiation. Protocols with reduced radiation doses but without compromising study quality need to be devised. Objectiveâ To study the viability of a CT protocol with suppression of the precontrast phase, for evaluating pediatric abdominal neoplasms, with consequent reduction of the radiation dose. Methods- A case series study was performed, including all the abdominal CT scans on children and adolescents found in the archives of Centro de Hematologia e Oncologia PediÃtrica/IMIP between December 2005 and September 2006. Two radiologists separately evaluated each CT twice, with a two-month interval between evaluations. At each evaluation, the radiologists were separately asked to formulate the most probable diagnosis and decide whether tumor calcification was present or absent. The first evaluation was performed without the precontrast phase and the second was done with the whole scan. The agreement between the two methods, and between each method and the histopathological results, was measured with kappa statistics. The sensitivity and specificity of each method for diagnosing the more frequent neoplasms were also measured, using histopathological results as the gold standard. The sensitivity and specificity were also measured without the precontrast scan for detecting calcifications, using the whole-study evaluation as the gold standard. Results- A total of 131 CT scans were evaluated. The agreement between diagnoses from the two methods was almost perfect, for both radiologists. There was no statistically significant difference between the two methods and the histopathological results. The sensitivity and specificity of the two methods for the most frequent neoplasms were similar, using histopathological results as the gold standard. The evaluations without the precontrast phase showed good sensitivity and specificity for tumor calcifications. Conclusion- CT protocols without the precontrast phase are a viable alternative for evaluating abdominal neoplasms in children and adolescents, with reduction of the radiation dose without compromising study quality

ASSUNTO(S)

neoplasia abdominal - crianÃa tomografia computadoriza espiral â contraste endovenoso pediatria helical computed tomography, contrast media, pediatrics

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