Technique and clinical applications of full-inflation and end-exhalation controlled-ventilation chest CT in infants and young children.

BACKGROUND: The inability of young children to cooperate with breath holding limits the usefulness of chest CT.

OBJECTIVE: To describe the technique and utility of a non-invasive method called controlled-ventilation CT (CVCT) for obtaining motion-free full-inflation and end-exhalation images of the lung in infants and young children.

MATERIALS AND METHODS: Eighty-seven children (ages 1 week to 5 years, mean 2 years) underwent CVCT of the chest during suspended respiration at full-lung inflation and end-exhalation for a variety of clinical indications. Respiratory pauses were produced using conscious sedation and positive-pressure face-mask ventilation. Forty-one of 87 children had recordings of respiratory motion during CVCT.

RESULTS: Respiratory pause lengths increased with age (P < 0.003), were highly reproducible (r = 0.85), and lasted sufficiently long to be practical for full-inflation (24 +/- 9 s) and end-exhalation (12 +/- 5 s) CT scanning. Full-inflation CVCT was useful in evaluating tracheal and bronchial stenosis, bronchial wall thickening, early bronchiectasis, bronchial fistula, extent of interstitial fibrosis, and lung nodules. End-exhalation CVCT was useful in evaluating tracheomalacia and air trapping.

CONCLUSION: Controlled-ventilation chest CT is a practical and reliable technique that promises to be clinically useful for a number of clinical indications in infants and young children.