Department of Radiology, Sheffield Children's Hospital, Western Bank, Sheffield, S10 2TH, UK.
Pediatr Radiol. 2009 Nov;39(11):1203-8. doi: 10.1007/s00247-009-1362-y. Epub 2009 Sep 30.
Little is known about the radiation burden from fluoroscopy-guided insertions of nasojejunal tubes (NJTs) in children. There are no recommended or published standards of diagnostic reference levels (DRLs) available.
To establish reference dose area product (DAP) levels for the fluoroscopy-guided insertion of nasojejunal tubes as a basis for setting DRLs for children. In addition, we wanted to assess our local practice and determine the success and complication rates associated with this procedure.
Children who had NJT insertion procedures were identified retrospectively from the fluoroscopy database. The age of the child at the time of the procedure, DAP, screening time, outcome of the procedure, and any complications were recorded for each procedure. As the radiation dose depends on the size of the child, the children were assigned to three different age groups. The sample size, mean, median and third-quartile DAPs were calculated for each group. The third-quartile values were used to establish the DRLs.
Of 186 procedures performed, 172 were successful on the first attempt. These were performed in a total of 43 children with 60% having multiple insertions over time. The third-quartile DAPs were as follows for each age group: 0-12 months, 2.6 cGy cm(2); 1-7 years, 2.45 cGy cm(2); >8 years, 14.6 cGy cm(2). High DAP readings were obtained in the 0-12 months (n = 4) and >8 years (n = 2) age groups. No immediate complications were recorded.
Fluoroscopy-guided insertion of NJTs is a highly successful procedure in a selected population of children and is associated with a low complication rate. The radiation dose per procedure is relatively low.
对于儿童经荧光透视引导下插入鼻空肠管（NJT）的辐射量知之甚少。目前尚无推荐或公布的诊断参考水平（DRL）标准。
建立经荧光透视引导下插入鼻空肠管的参考剂量面积乘积（DAP）水平，以此作为制定儿童 DRL 的基础。此外，我们还希望评估我们的本地实践，并确定与该程序相关的成功率和并发症发生率。
从荧光透视数据库中回顾性地确定了进行 NJT 插入程序的儿童。记录了每个程序的儿童年龄、DAP、筛查时间、程序结果以及任何并发症。由于辐射剂量取决于儿童的大小，因此将儿童分为三个不同的年龄组。为每个组计算了样本量、平均值、中位数和第三四分位数 DAP。第三四分位数值用于建立 DRL。
在进行的 186 次操作中，有 172 次在首次尝试时成功。这些操作是在总共 43 名儿童中进行的，其中 60%的儿童随着时间的推移多次进行了插入。每个年龄组的第三四分位数 DAP 如下：0-12 个月，2.6 cGy cm(2)；1-7 岁，2.45 cGy cm(2)；>8 岁，14.6 cGy cm(2)。0-12 个月（n = 4）和>8 岁（n = 2）年龄组的 DAP 读数较高。未记录到即时并发症。
在选定的儿童人群中，经荧光透视引导下插入 NJT 是一项高度成功的操作，且并发症发生率低。每次操作的辐射剂量相对较低。
