Wet diapers create imaging artifacts

Jul 14, 2009

2009 07 14 16 28 07 275 Wet Diaper A 150 V2

An inappropriately timed call to nature by infants and toddlers wearing disposable diapers can create artifacts that conceal pertinent imaging findings, warn radiologists from Children's Hospital of Philadelphia in Pennsylvania.

Radiograph of newborn infant with congenital diaphragmatic hernia. Note mottled density overlying the lower pelvis caused by the wet disposable diaper. Image courtesy of Dr. Richard Markowitz.

To avoid the necessity of repeating an imaging procedure, all children who wear disposable diapers or toilet-training underwear should have these removed by a radiologic technologist prior to imaging the patient. This pragmatic advice about wet diaper artifacts was published in the May-June issue of Clinical Imaging (2009, Vol. 33:3, pp. 226-230).

Dr. Richard Markowitz, a pediatric radiologist and president of the hospital's medical staff, and colleagues noticed that fluid absorbed by a wet disposable diaper appears as a myriad of small, coalescent nodular densities that have CT attenuation and MR signal characteristics. Standard radiographs also are affected.

The artifacts can obscure relevant radiographic findings, including calcifications, hernias, or pneumatosis intestinalis. They also may be misinterpreted as excreted contrast material, feces, or some other type of radiopaque material.

Dry diapers that contain an absorbent polymer pad produce no artifacts. Nor do cloth diapers, whether wet or dry.