Schmitz-Feuerhake I, Pflugbeil S, Pflugbeil C
Gesundheitswesen. 2010 Apr;72(4):246-54. doi: 10.1055/s-0029-1215570. Epub 2009 Jun 23.
A complete assessment of late effects of X-ray diagnostics should take into account that radiation sensitivity varies considerably for the different ages at exposure and, furthermore, that not only malignant diseases but also benign neoplasms are induced which also may lead to severe detriment of the patient. Risk estimates are derived for paediatric head CTs as well as for brain tumours in adults. Dose-effect relationships for tumours of the brain, skin, thyroid, and other sites of the head region, leukaemia, and cataracts are taken from the literature. On the basis of estimates for Germany about the number of head scans, the annual rate of radiation-induced diseases is calculated. 1,000 annual paediatric CT investigations of the skull will lead to about 3 excess neoplasms in the head region, i.e., the probability of an induced late effect must be suspected in the range of some thousandths. Additionally, a relevant increase of cataracts must be considered. The radiation-induced occurrence of meningiomas and other brain tumours most probably contributes to the continuously increasing incidence of these diseases which is observed in several industrial nations, as well as the exposure of the bone marrow by CT to the increase of childhood leukaemia.
对X射线诊断后期影响的全面评估应考虑到,辐射敏感性在不同暴露年龄时差异很大,此外,不仅会诱发恶性疾病,还会诱发良性肿瘤,这也可能给患者带来严重损害。推导了儿科头部CT以及成人大脑肿瘤的风险估计值。大脑、皮肤、甲状腺及头部其他部位的肿瘤、白血病和白内障的剂量效应关系取自文献。根据德国头部扫描数量的估计,计算辐射诱发疾病的年发生率。每年1000次儿科颅骨CT检查将导致头部区域约3例额外肿瘤,即诱发后期影响的概率必须怀疑在千分之几的范围内。此外,还必须考虑白内障的相关增加。辐射诱发的脑膜瘤和其他脑肿瘤很可能导致在几个工业国家观察到的这些疾病发病率持续上升,以及CT对骨髓的照射导致儿童白血病增加。