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Comparison of Effective Doses for Low-Dose MDCT and Radiographic Examination of Sinuses in Children

T. H. Mulkens1, C. Broers2, S. Fieuws3, J.-L. Termote1 and P. Bellnick1

1 Department of Radiology, Heilig Hart Hospital, Kolveniersvest 20, 2500 Lier, Belgium.
2 Department of Pediatrics, Heilig Hart Hospital, 2500 Lier, Belgium.
3 School of Public Health, Biostatistical Centre, Katholieke Universiteit Leuven, University Hospital St. Rafael, Leuven, Belgium.



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  		Fig. 1A. —Box plot of effective dose distribution in children for standard radiography and both CT phases (A) and each CT group (B). Rx = radiography.

 


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  		Fig. 1B. —Box plot of effective dose distribution in children for standard radiography and both CT phases (A) and each CT group (B). Rx = radiography.

 


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  		Fig. 2A. —Normal low-dose CT examination of sinuses of 14-year-old boy (16-MDCT, phase 1; effective dose, 0.11 mSv). 2.5-mm axial image shows normal maxillary and sphenoid sinuses.

 


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  		Fig. 2B. —Normal low-dose CT examination of sinuses of 14-year-old boy (16-MDCT, phase 1; effective dose, 0.11 mSv). 2.5-mm coronal image shows normal maxillary and ethmoid sinuses.

 


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  		Fig. 3A. —Normal low-dose CT examination of sinuses of 11-year-old boy (6-MDCT, phase 2; effective dose, 0.045 mSv). 2.5-mm-thick axial image shows normal ethmoid and sphenoid sinuses.

 


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  		Fig. 3B. —Normal low-dose CT examination of sinuses of 11-year-old boy (6-MDCT, phase 2; effective dose, 0.045 mSv). 2.5-mm coronal image shows maxillary and ethmoid sinuses.

 


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  		Fig. 4A. —3-year-old girl with recurrent upper airway infections and nocturnal cough (6-MDCT, phase 2; effective dose, 0.065 mSv). Low-dose CT shows bilateral sinusitis signs with maxillary mucosal inflammation (5-mm thickness) and right ethmoid sinusitis with opacification of ethmoid cells (arrowhead).

 


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  		Fig. 4B. —3-year-old girl with recurrent upper airway infections and nocturnal cough (6-MDCT, phase 2; effective dose, 0.065 mSv). Sphenoid sinuses may be absent or very small in young children and mistaken for posterior ethmoid cells in axial or coronal images. Sagittal images can help identify them; normal right sphenoid sinus (asterisk) and opacification of posterior ethmoid cells (arrowhead) are indicated.

 


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  		Fig. 4C. —3-year-old girl with recurrent upper airway infections and nocturnal cough (6-MDCT, phase 2; effective dose, 0.065 mSv). Sagittal 2-mm image shows slight mucosal thickening in left sphenoid sinus (double asterisks).

 


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  		Fig. 5A. —3-year-old girl with recurrent upper airway infections, cough, and open-mouth breathing (16-MDCT, phase 2; effective dose, 0.038 mSv). Axial image shows bilateral complete opacification of ethmoid (arrowheads) and sphenoid sinuses (asterisks) with bilateral fluid in middle ear cavities (double asterisks).

 


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  		Fig. 5B. —3-year-old girl with recurrent upper airway infections, cough, and open-mouth breathing (16-MDCT, phase 2; effective dose, 0.038 mSv). Coronal image shows complete opacification of maxillary (asterisks) and ethmoid (arrowheads) sinuses.

 


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  		Fig. 5C. —3-year-old girl with recurrent upper airway infections, cough, and open-mouth breathing (16-MDCT, phase 2; effective dose, 0.038 mSv). Sagittal image depicts ethmoid (arrowheads) and sphenoid (asterisk) sinusitis and adenoid hypertrophy (double asterisks).

 


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  		Fig. 6A. —1.5-year-old boy, with persistent upper airway infection, purulent nasal discharge, cough, and fever (6-MDCT, phase 2; effective dose, 0.088 mSv). Axial image shows bilateral ethmoid sinusitis (arrowheads) and bilateral otitis (asterisks).

 


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  		Fig. 6B. —1.5-year-old boy, with persistent upper airway infection, purulent nasal discharge, cough, and fever (6-MDCT, phase 2; effective dose, 0.088 mSv). Coronal image shows bilateral maxillary sinusitis (asterisks) and ethmoid sinusitis (arrowheads).

 


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  		Fig. 6C. —1.5-year-old boy, with persistent upper airway infection, purulent nasal discharge, cough, and fever (6-MDCT, phase 2; effective dose, 0.088 mSv). Coronal image centered at middle ears shows bilateral otitis (arrowheads).

 

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