Division of Urology, Comprehensive Kidney Stone Center, Duke University Medical Center, Durham, North Carolina, USA.
Curr Opin Urol. 2010 Mar;20(2):163-8. doi: 10.1097/MOU.0b013e3283353bd9.
Ionizing radiation is produced by many of the imaging studies used in the diagnosis, management, and follow-up of patients with urolithiasis. Knowing the small, but significant, risks of solid and hematological malignancies associated with increased radiation exposure, our purpose is to discuss new imaging modalities that limit radiation exposure without compromising the valuable information needed by clinicians for appropriate management.
Recent studies suggest that many patients with urolithiasis may be subjected to relatively high doses of ionizing radiation during acute stone episodes and throughout the management of their disease, due, in large part, to the rapidly increasing usage of computed tomography (CT). Certain imaging modalities, most notably low-dose CT, have shown promise in reducing radiation dose to patients while maintaining comparable sensitivity and specificity to standard CT, under most conditions.
Urologists who use radiographic imaging in the care of their patients, must be aware of the risks of ionizing radiation. Accordingly, every effort must be made to limit radiation exposure, especially in the most susceptible populations. In our view, low-dose CT is currently the best imaging modality for patients with urolithiasis, as it offers adequate image quality with much reduced radiation exposure.
尿路结石患者的诊断、治疗和随访中常需要进行多种影像学检查，这些检查会产生电离辐射。我们知道，在接触更多电离辐射的情况下，患实体瘤和血液系统恶性肿瘤的风险虽然较小，但意义重大。因此，我们旨在讨论新的影像学方法，这些方法在不影响临床医生进行适当治疗所需的有价值信息的情况下，限制辐射暴露。
最近的研究表明，由于 CT 检查的使用迅速增加，尿路结石患者在急性结石发作期间和疾病治疗过程中可能会受到相对较高剂量的电离辐射。某些影像学方法，尤其是低剂量 CT，在大多数情况下显示出在保持与标准 CT 相当的敏感性和特异性的同时，降低患者辐射剂量的潜力。
在为患者提供影像学检查的过程中，泌尿外科医生必须意识到电离辐射的风险。因此，必须尽一切努力限制辐射暴露，尤其是在最易感的人群中。在我们看来，低剂量 CT 是目前尿路结石患者的最佳影像学检查方法，因为它提供了足够的图像质量，同时辐射暴露大大减少。
