Use of photon-counting CT and three-dimensional printing for an intra-thoracic retained ballistic fragment in a 9-year-old.

IF 2.1 3区医学 Q2 PEDIATRICS

Pediatric Radiology Pub Date : 2025-02-17 DOI:10.1007/s00247-025-06185-7

Catherine B Beckhorn, Mary E Moya-Mendez, Michael Aiduk, Steven Thornton, Cathlyn K Medina, Anna D Louie, Douglas Overbey, Joseph Y Cao, Elisabeth T Tracy

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引用次数: 0

Abstract

Retained ballistic fragments from gunshot wounds pose diagnostic and management challenges for radiologists and surgeons alike. Imaging and clinical decision-making regarding removal warrant comprehensive risk/benefit discussions, considering anatomic location, complexity of surgical removal, and risk of long-term complications of bullet migration and potential lead toxicity. Herein, we describe a 9-year-old with a retained intra-thoracic para-aortic ballistic fragment causing elevated lead levels. Photon-counting detector computed tomography (PCD-CT) was used to create a 3D-printed anatomic model, critical for multidisciplinary pre-operative planning and as an educational tool with the patient and family, ultimately leading to successful surgical bullet removal. Since spectral CT imaging offers superior metal artifact reduction capabilities than conventional CT, cutting-edge technologies such as PCD-CT and 3D-printing should be considered in anatomically challenging cases.

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来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.