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Компьютерная томография при черепно-мозговой травме у младенцев и детей младшего возраста (обзор литературы)

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Цель исследования: проанализировать последние исследования, относящиеся к вопросам применения компьютерной томографии (КТ) при черепно-мозговой травме (ЧМТ) у детей раннего возраста. Результаты. ЧМТ - одна из частых причин смерти и инвалидности у детей. Детская ЧМТ связана с рядом характеристик, отличающих ее от взрослых. Это обусловлено возрастными анатомо-физиологические различиями, зависящими от физического состояния ребенка и трудностями с неврологической оценкой у детей. Дети раннего возраста проявляют специфические патологические реакции на ЧМТ с четкими сопутствующими неврологическими проявлениями. В этом обзоре представлена важная информация о текущих аспектах использования КТ при всех видах изолированной тупой ЧМТ у детей в возрасте от рождения до 3 лет с учетом особенностей, соответствующих возрасту в условиях неотложной помощи. Хотя механизмы ЧМТ у раннего возраста аналогичны взрослым, визуальные проявления травм головы у детей имеют свои особенности из-за развивающегося мозга и свода черепа. Основная роль радиолога - определить и охарактеризовать тип и степень тяжести травмы головы, чтобы помочь правильному ведению пациента. Исходя из информации, полученной при КТ, зная механизм ЧМТ у младенцев и детей раннего возраста, радиологи играют ключевую роль как в диагностике, так и в выборе эффективного лечения и улучшении результатов лечения и исходов. Заключение. КТ головы с многоплановыми и 30-реконструкциями в настоящее время заменила рентгенографию черепа при подозрения на ЧМТ и стала важнейшим диагностическим методом у пациентов с ЧМТ в условиях неотложной помощи. Рентгенограммы не добавляют дополнительной диагностической информации и могут быть исключены из исследования в случае проведения КТ с 30-реконструкцией.

Ключевые слова:
черепно-мозговая травма головы, дети, младенцы, компьютерная томография, traumatic brain injury, children, infants, computed tomography

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Computed tomography of traumatic brain injury in infants and young children (a literature review)

Objective. To analyze recent studies related to the use of computed tomography in traumatic brain injury in young children. Results. Traumatic brain injury (TBI) is one of the most common causes of death and disability in children. Pediatric TBI has a number of characteristics different of adults. This is due to age-related anatomical and physiological differences depending on patient''s physical condition and on problems with his/her neurological assessment. Young children demonstrate specific pathological reactions to TBI with clear concomitant neurological manifestations. The authors present an important information on current aspects of CT application for all types of isolated blunt TBI in children aged from birth to 3 years with consideration of age-appropriate characteristics and emergency condition. Although TBI mechanisms are similar in young children and adults, visual manifestations of head injury in children have their own specific features due to the developing brain and cranial vault. Radiologist''s primary role is to identify and characterize the type and severity of head injury so as to assist the correct management of the patient. Using the information obtained from CT examination and knowing TBI mechanisms in infants and young children, a radiologist can play a key role both in diagnostics and in selection of effective care, thus improving clinical outcomes. Conclusion. Head CT with multifaceted and 3D reconstructions has now replaced X-ray examination of the skull in suspected TBI and has become the most important diagnostic technique in patients with TBI at emergency settings. Radiographs do not provide with additional diagnostic information and may be excluded from the examination, if CT with 3D reconstruction are planned to perform or has already been performed.

Keywords:
черепно-мозговая травма головы, дети, младенцы, компьютерная томография, traumatic brain injury, children, infants, computed tomography