Comparison of image quality of abdominopelvic CT in paediatric patients: low osmolar contrast media versus less iodine-containing iso-osmolar contrast media at different peak kilovoltages

• Published in: Clinical radiology Vol. 74; no. 11; pp. 896.e9 - 896.e16
• Main Authors: Kim, M., Hwang, J.Y., Choo, K.S., Ryu, H., Reid, S.N.S., Kim, Y.W., Kim, T.U., Kim, J.H.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2019
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2019.06.027

To evaluate the effect of iso-osmolar contrast media (IOCM) at different tube voltages on image quality for abdominal computed tomography (CT) in paediatric patients. The low osmolar contrast media (LOCM) group and IOCM group consisted of 101 and 102 CT examinations, respectively, in patients <18 years old. Images were reviewed retrospectively. Objective measurement of the contrast enhancement and noise were analysed and contrast-to-noise ratios (CNRs) of the abdominal aorta, portal vein, and liver were calculated. Four radiologists participated in subjective analysis using a four-point scale system to evaluate degrees of contrast enhancement, image noise, beam-hardening artefact, and overall image quality. Reader performance for correctly differentiating the two kinds of contrast media was evaluated. Regarding the objective measurement, contrast enhancement was significantly higher in the LOCM group (p<0.05). In subjective analysis, only CT using 120 kVp showed significantly stronger enhancement in the LOCM group (p=0.002), and sensitivity to differentiate the IOCM was 80.6%. Overall sensitivity and specificity for correctly differentiating IOCM were 57.1%, and 56.9%, respectively. The application of IOCM was found to be feasible for performing paediatric abdominopelvic CT with a low tube voltage protocol. Although objective measurements of contrast enhancement were significantly lower in the IOCM group, subjective contrast enhancement and image quality assessments were not statistically different between groups. •Evaluating the abdominal CT quality in pediatrics when using IOCM compared with LOCM, by objective and subjective analysis.•In objective analysis, IOCM group showed significantly less enhancement compared to LOCM group.•Liver enhancement showed diagnostic quality in both groups.•In subjective analysis, the enhancement degree was only significantly different for the subjects using 120 kVp.