Gherardi Guy G, Iball Gareth R, Darby Michael J, Thomson John D R
School of Medicine, Leeds Institute of Medical Education, University of Leeds, United Kingdom.
Cardiol Young. 2011 Dec;21(6):616-22. doi: 10.1017/S1047951111000485. Epub 2011 May 10.
The use of imaging that employs ionising radiation is increasing in the setting of paediatric cardiology. Children's high radiosensitivity and the lack of contemporary radiation data warrant a review of the radiation doses from the latest "state-of-the-art" angiography and computed tomography systems.
In children aged less than 16 years with congenital cardiac disease, we aimed to report: recent trends in the use of diagnostic angiography and cardiac dual-source computed tomography; the characteristics, lesions, and imaging histories of patients undergoing these procedures; and the average radiation doses imparted by each modality.
Retrospective review of consecutive cases undergoing cardiac computed tomography or diagnostic angiography in a teaching hospital between January, 2008 and December, 2009. Radiation doses were converted to effective doses (millisievert) using published conversion factors.
Angiography was performed 3.7 times more often than computed tomography. Computed tomography examinations increased by 92.5%, whereas angiography decreased by 26.4% in 2009 compared with 2008. Patients undergoing computed tomography were younger and weighed less than those undergoing angiography, but lesions were similar between the 2 groups. Multiple lifetime angiography was more prevalent than multiple lifetime computed tomography (p < 0.001). The median procedural dose - range - from angiography and computed tomography was 5 (0.2-27.8) and 1.7 (0.5-9.5) millisieverts, respectively (p < 0.001).
Despite not being completely analogous investigations, computed tomography should be considered prior to angiography and not withheld on radiation dose concerns, given that it imparts lower and more consistent doses than conventional angiography.
在儿科心脏病学领域，使用电离辐射的成像技术正在增加。儿童的高辐射敏感性以及缺乏当代辐射数据，使得有必要对最新的“先进”血管造影和计算机断层扫描系统的辐射剂量进行回顾。
对于年龄小于16岁的先天性心脏病患儿，我们旨在报告：诊断性血管造影和心脏双源计算机断层扫描的近期使用趋势；接受这些检查的患者的特征、病变和成像史；以及每种检查方式的平均辐射剂量。
对2008年1月至2009年12月在一家教学医院接受心脏计算机断层扫描或诊断性血管造影的连续病例进行回顾性研究。使用已发表的转换因子将辐射剂量转换为有效剂量（毫西弗）。
血管造影的实施频率比计算机断层扫描高3.7倍。与2008年相比，2009年计算机断层扫描检查增加了92.5%，而血管造影减少了26.4%。接受计算机断层扫描的患者比接受血管造影的患者年龄更小、体重更轻，但两组的病变相似。多次终身血管造影比多次终身计算机断层扫描更普遍（p<0.001）。血管造影和计算机断层扫描的中位程序剂量范围分别为5（0.2 - 27.8）和1.7（0.5 - 9.5）毫西弗（p<0.001）。
尽管这两种检查并非完全类似，但鉴于计算机断层扫描比传统血管造影的剂量更低且更一致，在进行血管造影之前应考虑使用计算机断层扫描，而不应因辐射剂量问题而不采用。
