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儿科尿动力学检查中的辐射暴露。

Radiation exposure during pediatric videourodynamics.

机构信息

Stanford University School of Medicine, Stanford, California 94305, USA.

出版信息

J Urol. 2011 Oct;186(4 Suppl):1672-6. doi: 10.1016/j.juro.2011.04.014.

Abstract

PURPOSE

Videourodynamics is useful for evaluating and treating neurological disorders in children. Traditional urodynamic parameters can be obtained while simultaneous visualization of the urinary system can reveal anatomical anomalies. This additional information comes at the cost of radiation exposure to the child. We characterized radiation exposure from videourodynamics.

MATERIALS AND METHODS

We reviewed all recent videourodynamic studies and recorded patient demographics, urological diagnoses, physical attributes, total fluoroscopy time, total radiation exposure in mGy, bladder capacity and the number of filling cycles performed. Multivariate linear regression was used to identify patient factors that independently influenced total radiation exposure.

RESULTS

A total of 64 videourodynamic studies were performed in 34 female and 28 male patients with a mean age of 8.6 years (95% CI 7.2-10.0). The most common diagnosis was neurogenic bladder in 40 patients, although 49 had multiple diagnoses. Mean total fluoroscopy time was 1.8 minutes (95% CI 1.4-2.1) and mean total radiation exposure was 10 mGy (95% CI 7.5-13.3). On multivariate linear regression patient weight and bladder capacity were the only independent predictors of total radiation exposure.

CONCLUSIONS

Videourodynamics entail significant radiation exposure. Patient weight and bladder capacity were independent predictors of total radiation exposure. Physician awareness of radiation exposure may result in the judicious use of fluoroscopy and aid in counseling parents on the risk of videourodynamics. Further research is needed to quantify organ specific doses of radiation due to medical imaging in children and the associated cancer risks.

摘要

目的

尿动力学视频检查有助于评估和治疗儿童的神经疾病。传统的尿动力学参数可以在同时对泌尿系统进行可视化的情况下获得,从而发现解剖异常。这些额外的信息是通过对儿童进行辐射暴露获得的。本研究旨在对尿动力学视频检查中的辐射暴露情况进行分析。

材料和方法

我们回顾了所有最近的尿动力学视频检查,并记录了患者的人口统计学数据、泌尿科诊断、身体特征、透视总时间、总辐射剂量(以 mGy 计)、膀胱容量和完成的充盈循环次数。采用多元线性回归分析确定独立影响总辐射暴露的患者因素。

结果

共对 34 名女性和 28 名男性患者进行了 64 项尿动力学视频检查,平均年龄为 8.6 岁(95%置信区间为 7.2-10.0)。最常见的诊断是神经源性膀胱,共 40 例,但 49 例患者有多种诊断。平均透视总时间为 1.8 分钟(95%置信区间为 1.4-2.1),平均总辐射剂量为 10 mGy(95%置信区间为 7.5-13.3)。多元线性回归分析显示,患者体重和膀胱容量是总辐射暴露的唯一独立预测因素。

结论

尿动力学视频检查会带来显著的辐射暴露。患者体重和膀胱容量是总辐射暴露的独立预测因素。医生对辐射暴露的认识可能会导致透视的合理使用,并有助于向父母告知尿动力学视频检查的风险。需要进一步研究来量化由于儿童医学成像而导致的器官特异性辐射剂量及其相关的癌症风险。

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