Department of Radiology, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
AJR Am J Roentgenol. 2010 Jun;194(6):1611-9. doi: 10.2214/AJR.09.3771.
The purpose of our study was to measure patient size on CT images as a function of age at a large tertiary care children's hospital to develop current patient size data for modeling optimal x-ray exposure factors in children.
Anteroposterior and transverse dimensions of the head, thorax, abdomen, and pelvis were measured on CT examinations of pediatric patients less than 21 years old performed between June and November 2007. Patients with diseases that could affect measurements were excluded. From 1,009 patients, 336 examinations of each of four body regions were selected; 2,688 measurements were made and separated into 21 groups. Statistical model building and prediction equations were established for each region and 95% prediction intervals were used for analyses.
Rapid growth of the head occurred from birth to approximately 2 years followed by a gradual plateau until 21 years. The thoracic, abdominal, and pelvic regions showed a linear relationship between age and size. Fitted equations showed transverse trunk measurements increased more rapidly than anteroposterior measurements. The anteroposterior trunk size growth rate was relatively region independent; transverse pelvic dimensions grew more rapidly than thoracic or abdominal regions. There was a broad overlap of predicted patient size ranges as a function of age within each region. Excellent interobserver agreement was measured by Pearson's correlation coefficient (r) (all p < 0.0001).
Fitted average patient sizes are age dependent; however, predicted individual patient size does not correlate well with age. Our study suggests that pediatric patient body size should be determined for individual patients before performing diagnostic imaging procedures that entail radiation risks.
我们的研究目的是测量大型三级儿童保健医院 CT 图像上的患者尺寸随年龄的变化,以建立当前的患者尺寸数据,为儿童最佳 X 射线曝光因素建模。
在 2007 年 6 月至 11 月期间对小于 21 岁的儿科患者进行 CT 检查,测量头部、胸部、腹部和骨盆的前后径和横径。排除可能影响测量的疾病的患者。从 1009 名患者中,选择每个身体部位的 336 次检查;共进行了 2688 次测量,并分为 21 组。为每个区域建立了统计模型构建和预测方程,并使用 95%预测区间进行分析。
头部从出生到大约 2 岁快速生长,然后逐渐趋于平稳,直到 21 岁。胸部、腹部和骨盆区域的大小与年龄呈线性关系。拟合方程显示,横断躯干测量值的增长速度快于前后径测量值。前后径躯干尺寸的生长速度相对区域独立;骨盆尺寸的横向增长速度快于胸部或腹部区域。在每个区域内,根据年龄预测患者尺寸范围存在广泛的重叠。观察者间的一致性通过 Pearson 相关系数(r)进行了很好的衡量(所有 p<0.0001)。
拟合的平均患者尺寸随年龄变化;然而,预测的个体患者尺寸与年龄相关性不大。我们的研究表明,在进行涉及辐射风险的诊断成像程序之前,应针对每个患者确定儿科患者的身体尺寸。