Tomosynthesis in pediatrics: a retrospective of its application in the world practice and own data

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Abstract

Tomosynthesis is a modern effective and informative method of low-dose X-ray diagnostics, which allows obtaining a significant number of layered images with the subsequent volumetric image reconstruction. The use of tomosynthesis provides a one-time examination of a large anatomical area without loss of the image quality and diagnostics of difficult-to-visualize pathological changes that are not detected by digital radiography. The article presents an overview of the problem of improving low-dose imaging options in the radiation diagnostics, as well as the authors’ own data on the use of tomosynthesis for the diagnosis of community-acquired pneumonia in children.

About the authors

Hilda Y. Simonovskaya

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Author for correspondence.
Email: hildas@yandex.ru
ORCID iD: 0000-0001-6636-3371
SPIN-code: 9100-2773

Assistant Lecturer

Russian Federation, 20/1, Delegatskaya street, 127473, Moscow

Nataliya A. Sholokhova

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov; Children’s City Clinical Hospital of St. Vladimir

Email: sholohova@bk.ru
ORCID iD: 0000-0002-0412-4938
SPIN-code: 6865-2462

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, 20/1, Delegatskaya street, 127473, Moscow; Moscow

Olga V. Zaytseva

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: olga6505963@yandex.ru
ORCID iD: 0000-0003-3426-3426
SPIN-code: 3090-4876

MD, Dr. Sci. (Med.), Professor

Russian Federation, 20/1, Delegatskaya street, 127473, Moscow

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2. Fig. 1. Results of X-ray examination of the patient K., 16 years old, 6th day of the onset of disease. Primary radiografically was diagnosed upper lobe pneumonia (a). According to the results of tomosynthesis (б, в), also performed on the 6th day of the disease, the zone of the blackout captures the entire lower lobe of the left lung; destructive foci in segments 4 and 5 of the left lung (under suspicion). These data were the reasons for the revision (expansion) of the empirical antibacterial therapy.

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3. Fig. 2. Results of the X-ray examination of the patient A., 16 years old. Radiografically on the 4th day of the onset of disease was diagnosed lower lobe pneumonia on the right (a). During tomosynthesis (б), foci of destruction were visualized round foci of enlightenment in the lower and middle lobes on the right lung. The number, size and localization of which were confirmed by multispiral computed tomography later.

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4. Fig. 3. Results of the different examination in comparable periods of the patient D., 1 year 8 months, with subtotal right-sided destructive pneumonia: a — radiography; б — tomosynthesis; в — multispiral computed tomography.

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Copyright (c) 2021 Simonovskaya H.Y., Sholokhova N.A., Zaytseva O.V.

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