Exposure to low-dose ionizing radiation from medical imaging procedures.
Exposure to low-dose ionizing radiation from medical imaging procedures.
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DOI：
10.1056/nejmoa0901249
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发表时间：
2009-08-27
期刊：
影响因子：
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通讯作者：
Nallamothu BK
中科院分区：
文献类型：
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作者：
Fazel R;Krumholz HM;Wang Y;Ross JS;Chen J;Ting HH;Shah ND;Nasir K;Einstein AJ;Nallamothu BK
在美国，越来越多的人使用成像程序，这引发了人们对普通民众暴露于低剂量电离辐射的担忧。我们在2005年7月1日至2007年12月31日期间在全美5个医疗保健市场确定了952,420名非老年成年人。利用数据来确定成像过程中辐射的累积有效剂量，单位为毫西弗(MSv)，并计算基于人群的“中”(每年3至20 mSv)、“高”(每年20至50 mSv)和“极高”(每年50 mSv)剂量。在研究期间，655,613人(68.8%)接受了至少一次与辐射暴露相关的成像程序。来自成像程序的平均有效剂量为每人每年2.4mSv(STD dev，6.0mSv)；但分布广泛，平均有效剂量为每人每年0.1mSv(四分位数范围为0.0至1.7)。总体而言，研究人群中中等有效剂量的年率为每1,000人193.8人，而高剂量和极高剂量的年率分别为每1,000人18.6人和每1,000人1.9人。一般来说，成像过程中的有效辐射剂量随着年龄的增长而增加，女性的辐射剂量更高。计算机断层扫描和核医学扫描占总有效剂量的75.4%，81.8%发生在非住院环境中。成像程序是美国电离辐射的重要来源，可能会导致患者受到高剂量的辐射。
Growing use of imaging procedures in the United States has raised concerns about exposure to low-dose ionizing radiation in the general population. We identified 952,420 non-elderly adults in 5 healthcare markets across the United States between July 1, 2005 and December 31, 2007. Utilization data were used to determine cumulative effective doses of radiation from imaging procedures in millisieverts (mSv) and to calculate population-based rates of “moderate” (>3 to 20 mSv per year), “high” (>20 to 50 mSv per year) and “very-high” (>50 mSv per year) doses. During the study period, 655,613 (68.8%) individuals underwent at least 1 imaging procedure associated with radiation exposure. The mean effective dose from imaging procedures was 2.4 mSv per person per year (std dev, 6.0 mSv); however, a wide distribution was noted with a median effective dose of 0.1 mSv per person per year (interquartile range, 0.0 to 1.7). Overall, the annual rate for moderate effective doses in the study population was 193.8 per 1000 enrollees, while high and very-high doses occurred at annual rates of 18.6 per 1000 enrollees and 1.9 per 1000 enrollees, respectively. In general, effective doses of radiation from imaging procedures increased with advancing age and were higher in women. Computed tomography and nuclear medicine scans accounted for 75.4% of the total effective dose and 81.8% occurred in non-hospitalized settings. Imaging procedures are an important source of ionizing radiation in the United States and can lead to high radiation doses in patients.