Effective Radiation Dose in Computed Tomographic Angiography of the Chest and Diagnostic Cardiac Catheterization in Pediatric Patients
Effective Radiation Dose in Computed Tomographic Angiography of the Chest and Diagnostic Cardiac Catheterization in Pediatric Patients
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DOI：
10.1007/s00246-012-0486-2
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发表时间：
2013-03
影响因子：
1.6
通讯作者：
Timotheus Watson;E. Mah;U. Joseph Schoepf;Lydia B. King;W. Huda;A. Hlavacek
中科院分区：
文献类型：
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作者：
Timotheus Watson;E. Mah;U. Joseph Schoepf;Lydia B. King;W. Huda;A. Hlavacek
CT血管造影术(CTA)和心导管术是超声心动图显示儿童心血管解剖结构的有用辅助手段。这些研究需要电离辐射，了解儿科患者在进行这些测试时受到的辐射量是至关重要的。现代剂量学方法有助于将不同单位的辐射剂量转换为有效辐射剂量。目的：比较儿童胸部非常规CTA与诊断性心导管检查的有效辐射剂量。这是一项对2009年7月至2010年4月间接受胸部非常规CTA或诊断性心导管插入术的患者进行的回顾性队列研究。每组包括50名患者，作为单一三级护理中心的连续样本。每组的有效辐射剂量(MSv)用换算系数表示。CTA组的中位有效剂量(ED)为0.74mSv，而插管组为10.8mSv(p<；0.0001)。CTA组1岁儿童ED的中位数为0.76mSv，而导管组为13.4mSv(P<；0.0001)。与诊断性心导管插入术相比，胸部无创CTA使儿童暴露在比诊断性心导管手术少15倍的辐射中。除非血流动力学数据是必要的，否则，对于已知或推测患有心脏病的患者，在超声心动图以外需要额外成像的患者，应考虑胸部CTA以代替诊断性心导管检查。
Computed tomographic angiography (CTA) and cardiac catheterization are useful adjuncts to echocardiography for delineating cardiovascular anatomy in pediatric patients. These studies require ionizing radiation, and it is paramount to understand the amount of radiation pediatric patients receive when these tests are performed. Modern dosimetry methods facilitate the conversion of radiation doses of varying units into an effective radiation dose. To compare the effective radiation dose between nongated CTA of the chest and diagnostic cardiac catheterization in pediatric patients. This is a retrospective cohort study of patients of patients who underwent either nongated CTA of the chest or diagnostic cardiac catheterization between July 2009 and April 2010. Fifty patients were included in each group as consecutive samples at a single tertiary care center. An effective radiation dose (mSv) was formulated using conversion factors for each group. The median effective dose (ED) for the CTA group was 0.74 mSv compared with 10.8 mSv for the catheterization group (p< 0.0001). The median ED for children <1 year of age in the CTA group was 0.76 mSv compared with 13.4 mSv for the catheterization group (p< 0.0001). Nongated CTA of the chest exposes children to 15 times less radiation than diagnostic cardiac catheterization. Unless hemodynamic data are necessary, CTA of the chest should be considered in lieu of diagnostic cardiac catheterization in patients with known or presumed cardiac disease who need additional imaging beyond echocardiography