Department of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico 87131, USA.
JACC Cardiovasc Imaging. 2010 May;3(5):517-24. doi: 10.1016/j.jcmg.2009.11.017.
Clinical decision-making regarding the use of low-level ionizing radiation for diagnostic and/or therapeutic purposes in patients with cardiovascular disease must, as in all other clinical scenarios, encompass the broad range of the risk-benefit ratio. Concerns regarding the late carcinogenic effects of exposure to low levels, i.e., <100 mSv, of ionizing radiation stem from extrapolation of exposure-outcome data in survivors of World War II atomic bomb explosions. However, ongoing debate regarding the true incremental risk to subjects exposed to doses currently administered in cardiovascular procedures fails to take into account the uncertainty of the dose-response relationship in this lower range, as well as tissue-specific reparative responses, also manifest at lower levels of exposure. The present discussion draws attention to both of these aspects as they relate to clinical decision-making.
在心血管疾病患者中，出于诊断和/或治疗目的而使用低水平电离辐射的临床决策，必须像在所有其他临床情况下一样，涵盖风险-效益比的广泛范围。对接触低水平（即<100mSv）电离辐射的迟发性致癌作用的担忧，源于对二战原子弹爆炸幸存者的暴露-结局数据的推断。然而，目前针对在心血管程序中接受目前所施剂量的受试者的真正增量风险的持续争论，未能考虑到在这个较低范围内剂量-反应关系的不确定性，以及在较低暴露水平下也表现出来的组织特异性修复反应。目前的讨论提请注意这两个方面，因为它们与临床决策有关。
