RadteraPediatric CT Abdomen/Pelvis (Low Dose)
CT+ ContrastPediatricverify
Indications
- Appendicitis (when US inconclusive), trauma, abscess
- Abdominal mass/oncologic evaluation, inflammatory bowel disease
- Acute abdomen when ultrasound/MRI insufficient
Patient prep
- Image Gently—weight-based dosing and contrast
- Oral contrast per institution (often omitted in trauma/appendicitis with modern scanners); neutral or positive depending on indication
- Weight-based IV contrast; ensure IV access appropriate to child size
- Immobilization; child life support; minimize phases
Contrast
Agentiodinated (iohexol/iopamidol); weight-based
RouteIV (+/- oral per indication)
DoseWeight-based ~1.5-2 mL/kg IV at age-appropriate rate (small-gauge IV may limit rate)
TimingSingle portal venous phase ~60-70 s for most indications; tailor (single-phase preferred to limit dose)
Technique
- Supine, arms up if tolerated; coverage diaphragm through pubic symphysis (limit to region of interest when possible)
- Weight/size-based kV (80-100 kV common) and mAs; iterative reconstruction
- Single phase whenever possible to minimize dose
- Thin recon 1.25-3 mm with coronal reformats
- Avoid multiphase unless specifically indicated
Series / Sequences
| # | Series / Sequence | Plane | Thickness | Notes |
|---|---|---|---|---|
| 1 | Axial portal venous | axial | 2-3 mm | Single-phase, low dose |
| 2 | Coronal reformat | coronal | 2-3 mm | Bowel/overview |
| 3 | Thin axial | axial | 1.25 mm | Reformats |
Key points
- Image Gently: weight-based kV/mAs and contrast; single-phase imaging to minimize dose
- Ultrasound first-line for pediatric appendicitis; MRI alternative to avoid radiation
- Weight-based contrast (~1.5-2 mL/kg); small IV gauge may limit injection rate—adjust timing
- Limit Z-coverage to area of clinical concern
- Iterative reconstruction preserves quality at low dose
References
• ACR-SPR-SAR Practice Parameter for CT of the Abdomen/Pelvis; Image Gently Alliance
• ACR Appropriateness Criteria: Right Lower Quadrant Pain-Suspected Appendicitis (Child)
• Radiopaedia / Image Gently pediatric body CT ( link
• ACR Appropriateness Criteria: Right Lower Quadrant Pain-Suspected Appendicitis (Child)
• Radiopaedia / Image Gently pediatric body CT ( link
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.