UMass Memorial Medical Center, Worcester, MA 01655, USA.
J Pediatr Surg. 2011 Jan;46(1):188-91. doi: 10.1016/j.jpedsurg.2010.09.088.
BACKGROUND/PURPOSE: Although ultrasound is often the preferred pediatric imaging study, many institutions lack ultrasound access at night; and computerized tomography (CT) becomes the only radiological method available for evaluation of appendicitis in children. The purpose of this study was to characterize patterns of daytime and nighttime use of ultrasound or CT for evaluation of pediatric appendicitis and to measure consequent differences in radiation exposure and cost.
A retrospective chart review of patients evaluated for appendicitis from October 2004 to October 2009 (N = 535) was performed to evaluate daytime and nighttime use of ultrasound and CT for pediatric patients.
Average age was 10.2 years (range, 3-17 years). During the day, 6 times as many ultrasounds were performed as CTs (230 vs 35). At night, half as many ultrasounds were performed (50 vs 110). Average radiation dose per child during the day was significantly lower than at night (day, 0.52 mSv per patient; night, 2.75 mSv per patient). Average radiology costs were lower for daytime patients ($2491.06 day vs $4045.00 night; P < .05).
Dependence on CT at night results in higher average radiation exposure and cost. Twenty-four-hour ultrasound availability would decrease radiation exposure and cost of evaluation of children presenting with appendicitis.
背景/目的：虽然超声通常是儿科首选的影像学研究方法，但许多机构在夜间缺乏超声设备；并且计算机断层扫描（CT）成为评估儿童阑尾炎的唯一可用放射学方法。本研究的目的是描述日间和夜间使用超声或 CT 评估小儿阑尾炎的模式，并测量相应的辐射暴露和成本差异。
回顾性分析 2004 年 10 月至 2009 年 10 月期间（N = 535）评估阑尾炎的患者的图表，以评估日间和夜间使用超声和 CT 对儿科患者的情况。
平均年龄为 10.2 岁（范围，3-17 岁）。白天进行的超声检查次数是 CT 检查的 6 倍（230 次与 35 次）。夜间，进行的超声检查次数减半（50 次与 110 次）。日间每名儿童的平均辐射剂量明显低于夜间（日间，0.52 毫希沃特/名患者；夜间，2.75 毫希沃特/名患者）。日间患者的平均放射学费用较低（日间 2491.06 美元，夜间 4045.00 美元；P <.05）。
夜间对 CT 的依赖导致平均辐射暴露和成本增加。24 小时超声可用性将降低评估阑尾炎患儿的辐射暴露和成本。
