Double low protocol in pediatric abdominal CT for evaluating right lower quadrant pain

作者：Hyun Jeong Park, Hyewon Choi, Rae Rim Ryu · 发表于：Japanese Journal of Radiology · 年份：2025 · 被引用次数：5 · 研究领域：Appendicitis Diagnosis and Management、Radiation Dose and Imaging、Abdominal Trauma and Injuries

PURPOSE: In pediatric patients, minimizing radiation and contrast media exposure without compromising diagnostic accuracy is paramount. Double low protocol, which utilizes a low dose contrast concentration and low tube voltage, could be a safer alternative. We compare diagnostic efficacy of double low protocol (Group A, 240 mgI/ml + 80 kVp) with conventional protocol (Group B, 350 mgI/ml + 120 kVp) in pediatric patients (< 10 years) presenting with abdominal pain and suspected acute appendicitis. MATERIALS AND METHODS: This retrospective study included 121 pediatric patients who underwent enhanced abdominal CT between January 2019 and February 2023: 62 with Group A and 59 with Group B. We compared radiation dose, iodine load, and quantitative image quality parameters. Two radiologists independently assessed diagnostic image quality on a 5-point scale, visualization of the appendix, and diagnostic performance for acute appendicitis and its complications. RESULTS: There were no significant differences in mean age (7.6 ± 2.0 vs. 7.6 ± 2.1, p = 0.956), body weight (31.4 ± 11.2 kg vs. 31.7 ± 11.4 kg, p = 0.972), and contrast media volume used (59.3 ± 21.0 ml vs. 65.0 ± 20.0 ml, p = 135) between the two groups. However, effective dose and iodine load used were significantly lower in Group A compared to Group B (2.7 ± 1.1 mSv vs. 4.3 ± 1.5 mSv and vs. 12.7 ± 4.6gI vs.18.6 ± 6.7gI, all p < 0.001). Although diagnostic image quality, noise and signal-to-noise ratio were significantly l...