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Technique, pitfalls, quality, radiation dose and findings of dynamic 4-dimensional computed tomography for airway imaging in infants and children

Research output: Contribution to journalArticle

  • Savvas Andronikou
  • Mark Chopra
  • Simon Langton-Hewer
  • Pia Maier
  • Jon Green
  • Emma Norbury
  • Sarah Price
  • Mary Smail
Original languageEnglish
Pages (from-to)678-686
Number of pages9
JournalPediatric Radiology
Issue number5
Early online date25 Jan 2019
DateAccepted/In press - 19 Dec 2018
DateE-pub ahead of print - 25 Jan 2019
DatePublished (current) - 1 May 2019


This retrospective review of 33 children’s dynamic 4-dimensional (4-D) computed tomography (CT) images of the airways, performed using volume scanning on a 320-detector array without anaesthesia (free-breathing) and 1.4-s continuous scanning, was undertaken to report technique, pitfalls, quality, radiation doses and findings. Tracheobronchomalacia (airway diameter collapse >28%) was recorded. Age-matched routine chest CT scans and bronchograms acted as benchmarks for comparing effective dose. Pitfalls included failure to administer intravenous contrast, pull back endotracheal tubes and/or remove nasogastric tubes. Twenty-two studies (67%) were diagnostic. Motion artefact was present in 16 (48%). Mean effective dose: dynamic 4-D CT 1.0 mSv; routine CT chest, 1.0 mSv, and bronchograms, 1.4 mSv. Dynamic 4-D CT showed tracheobronchomalacia in 20 patients (61%) and cardiovascular abnormalities in 12 (36%). Fourteen children (70%) with tracheobronchomalacia were managed successfully by optimising conservative management, 5 (25%) underwent surgical interventions and 1 (5%) died from the presenting disorder.

    Research areas

  • Airways, Bronchus, Child, Computed tomography, Radiation dose, Trachea, Tracheobronchomalacia

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