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Clinical utility and radiation exposure assessment of radiography and CT in pediatric cervical spine disorders
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M. Bao   , Y. Ding , H. Wu |
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Abstract: (14 Views) |
Background: Cervical spine injuries in children are uncommon but carry significant morbidity. Conventional radiography remains the initial imaging modality due to low radiation exposure, while computed tomography (CT) offers superior diagnostic accuracy at higher radiation dose. This study assessed the clinical utility, diagnostic performance, and radiation exposure of radiography versus CT in pediatric patients with suspected cervical spine disorders. Materials and Methods: This retrospective cohort study included 200 pediatric patients (<18 years) who underwent cervical spine radiography, CT, or both between January and December 2025. Diagnostic performance, incremental value of CT, clinical utility, image quality, and effective radiation doses (mSv) were evaluated. Age-stratified analyses and multivariable regression were performed. Results: Radiography showed 71.8% sensitivity and 95.4% specificity (accuracy 89.5%). CT identified 11 occult fractures and 8 ligamentous injuries missed on radiography, altering diagnosis in 17.7% and management in 15.6% of cases. High clinical utility was noted in 48% of radiographic and 76% of CT examinations (p < 0.001). Mean effective dose was 0.07 ± 0.03 mSv for radiography versus 2.42 ± 0.91 mSv for CT (34.6-fold higher; p < 0.001), with greater doses in younger children. Image quality was diagnostically acceptable in >93% of cases. Conclusion: Radiography suffices for most low-risk cases with minimal radiation, while selective CT use in high-risk or inconclusive scenarios provides substantial diagnostic and management benefits that justify its radiation burden when optimized with pediatric protocols. |
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| Keywords: Cervical vertebrae, radiography, tomography, X-ray computed, radiation dosage, pediatrics. |
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Full-Text [PDF 1305 kb]
(6 Downloads)
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Type of Study: Original Research |
Subject:
Radiation Biology
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