Objectives: To carry out the assessment of CT scans in children at the Charles de Gaulle University Hospital Center (CGUPH). Patients and Methods: This was a retrospective collection descriptive cross-sectional study conducted from July 1 to November 29, 2021 in the Radiology Department of the CGUPH, having included computed tomography (CT) reports of patients under 18 years of age. The variables explored were the data reported on CT reports (type of scan, reason for examination, dose delivered, and abnormalities described). Results: Two hundred and ninety explorations were collected. The average age was 2.93 years with extremes of 0 and 17 years. The sex ratio was 1.35. Computed tomography scans mainly explored the cranioencephalic, spinal and abdominal stages. The most common reasons for exploration were fetal suffering and head injuries. The most frequently described lesions were anoxo-ischemic sequelar lesions. Mean irradiation doses were 1096 ± 670 mGy·cm for the cranial-encephalic stage, 603 ± 332 mGy·cm for the spine and 311 ± 395 mGy·cm for the thoracic stage. Conclusion: CT in children mainly explored the brain and concerned children under 5 years. Anatomical irradiation doses were higher than diagnostic reference levels in several countries. Optimization of scanning protocols and availability of MRI would reduce ionizing radiation in children.
References
[1]
Baysson, H., Journy, N., Rehel, J.L., Mezzarobba, M., Boudjemline, Y., Bonnet, D., et al. (2013) Suivid’enfants exposés aux rayonnements ionisants dans le cadre de procédures radiologiques à visée diagnostique. Radioprotection, 48, 97-113. https://doi.org/10.1051/radiopro/2012039
[2]
Meulepas, J.M., Smets, A.M.J.B., Nievelstein, R.A.J., Gradowska, P., Verbeke, J., Holscher, H.C., et al. (2017) Trends and Patterns of Computed Tomography Scan Use among Children in the Netherlands: 1990-2012. European Radiology, 27, 2426-2433. https://doi.org/10.1007/s00330-016-4566-1
[3]
Puchalski, A.L. and Magill, C. (2018) Imaging Gently. Emergency Medicine Clinics of North America, 36, 349-368. https://doi.org/10.1016/j.emc.2017.12.003
[4]
Nelson, T.R. (2014) Practical Strategies to Reduce Pediatric CT Radiation Dose. Journal of the American College of Radiology, 11, 292-299. https://doi.org/10.1016/j.jacr.2013.10.011
[5]
Adambounou, K., Sayoré, A. and Adjenou, K. (2020) Irradiation médicale diagnostique pédiatrique à Lomé (Togo): Caractéristiques socio-cliniques des enfants et profils des sources d’irradiation utilisées. Médecine Nucléaire, 44, 129. https://doi.org/10.1016/j.mednuc.2020.01.069
[6]
Aïda, I.T., Pakisba, A.O., Milckisédek, J.S., Bassole, W., Ouedraogo, N.A., Bicaba, D., et al. (2020) évaluation des Doses d’Exposition et Concordance Radio-Clinique des Examens Tomodensitométriques Pédiatriques au CHUSS de Bobo-Dioulasso. Health Sciences and Disease, 21, 39-42. http://hsd-fmsb.org/index.php/hsd/article/view/2277
[7]
N’goan-Domoua, A., Kouamé, N., Houé, J. and Kéita, A. (2013) La tomodensitométrie dans la prise en charge des pathologies. Revue Internationale des Sciences Médicales, 15, 20-24.
[8]
Morel, B., Jaudeau-Collart, A.C., Vallin, C., Petit, S., Pellier, I. and Sirinelli, D. (2017) Prise en compte de la radioprotection au cours des examens en imagerie diagnostique réalisés chez des enfants atteints de pathologies oncologiques. Revue d’Oncologie Hématologie Pédiatrique, 5, 120-123. https://doi.org/10.1016/j.oncohp.2017.10.002
[9]
Tchaou, M., Gnakadja, G.N., N’Timon, B., Sonhaye, L., Amadou, A., Agoda-Koussema, L.A., et al. (2016) Revue Des Doses d’Exposition Et Des Methode d’Optimisation En Tomodensitometrie (TDM) De l’Enfant Au Togo. European Scientific Journal, 12, 71-83. https://doi.org/10.19044/esj.2016.v12n6p56
[10]
Kouéta, F., Yougbaré, S.O.O., Dao, L., Dao, F., Yé, D. and Kam, K.L. (2011) Audit médical des décès néonatals selon le modèle des trois retards, en milieu hospitalier pédiatrique de Ouagadougou. Cahiers d’études et de recherches francophones/Santé, 21, 209-214. https://doi.org/10.1684/san.2011.0271
[11]
Patel, P.J., Kolawole, T.M., Mahdi, A.H. and Qteishat, W.A. (1986) Computed Tomography (CT) Scan Findings in Children with Seizures Only. Acta Neurologica Scandinavica, 74, 165-166. https://doi.org/10.1111/j.1600-0404.1986.tb04645.x
Niele, N., Plötz, F.B., Tromp, E., Boersma, B., Biezeveld, M., Douma, M., et al. (2022) Young Children with a Minor Traumatic Head Injury: Clinical Observation or CT Scan? European Journal of Pediatrics, 181, 3291-3297. https://doi.org/10.1007/s00431-022-04514-8
[14]
Achar, S. and Yamanaka, J. (2020) Back Pain in Children and Adolescents. American Family Physician, 102, 19-28.
[15]
Prasad, M., Vora, T., Agarwala, S., Laskar, S., Arora, B., Bansal, D., et al. (2017) Management of Wilms Tumor: ICMR Consensus Document. The Indian Journal of Pediatrics, 84, 437-445. https://doi.org/10.1007/s12098-017-2305-5
[16]
Savadogo, H., Kaboret, S., Ouermi, A.S., Kaboré, A. and Diarra, Y. (2022) Masses Abdominales Palpables Chez l’enfant au Centre Hospitalier Universitaire Pédiatrique Charles-de-Gaulle de Ouagadougou (Burkina Faso). Revue Africaine des Sciences Sociales et de la Santé Publique, 4, 81-89.
[17]
Douamba, S., Nagalo, K., Ouédraogo, I., Salia, O., Bandré, E. and Yé, D. (2019) Aspects Thérapeutiques et Évolutifs du Néphroblastome au Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle. Health Sciences and Disease, 20, 55-58. http://www.hsd-fmsb.org/index.php/hsd/article/view/1521
[18]
Esser, M., Tsiflikas, I., Kraus, M.S., Hess, S., Gatidis, S. and Schaefer, J.F. (2022) Effectiveness of Chest CT in Children: CT Findings in Relation to the Clinical Question. RöFo, 194, 281-290. https://doi.org/10.1055/a-1586-3023
[19]
Fenton, S.J., Hansen, K.W., Meyers, R.L., Vargo, D.J., White, K.S., Firth, S.D., et al. (2004) CT Scan and the Pediatric Trauma Patient—Are We Overdoing It? Journal of Pediatric Surgery, 39, 1877-1881. https://doi.org/10.1016/j.jpedsurg.2004.08.007
Akhtar, W., Ali, S., Arshad, M., Ali, F.N. and Nadeem, N. (2011) Focused Abdominal CT Scan for Acute Appendicitis in Children: Can It Help in Need? Journal of Pakistan Medical Association, 61, 474-476.
[22]
Roberts, S., Nixon, A.F., Meltzer, J.A. and Blumfield, E. (2017) Focused CT Using a Height-Adjusted Metric and the Umbilicus as a Landmark for Children Undergoing Evaluation for Appendicitis. Pediatric Radiology, 47, 294-300. https://doi.org/10.1007/s00247-016-3756-y
[23]
Adambounou, K., Kambiré, F., Adigo, A.M.Y., Akoha, S. and Adjenou, K. (2021) Analyse de la justification de l’irradiation médicale pédiatrique liée à la Tomodensitométrie (TDM) à Lomé (Togo). Journal of Medical Imaging and Radiation Sciences, 52, 277-285. https://doi.org/10.1016/j.jmir.2021.03.034
[24]
Solomon, D.Z., Ayalew, B., Dellie, S.T. and Admasie, D. (2020) Justification and Optimization Principles of ALARA in Pediatric CT at a Teaching Hospital in Ethiopia. Ethiopian Journal of Health Sciences, 30, 761-766. https://doi.org/10.4314/ejhs.v30i5.16
[25]
McHugh, K. (2015) CT Scanning in Children and Risk of Cancer: What Three Large-Scale Studies Have Demonstrated. Radiation Protection Dosimetry, 165, 10-12. https://doi.org/10.1093/rpd/ncv118
