Division of Pediatric Gastroenterology Hepatology and Nutrition, Emory University School of Medicine, Children's Hospital of Atlanta, Atlanta, GA, USA.
Inflamm Bowel Dis. 2011 Nov;17(11):2326-32. doi: 10.1002/ibd.21626. Epub 2011 Jan 13.
Children with inflammatory bowel disease (IBD) undergo imaging using ionizing radiation and may be exposed to high cumulative radiation. We hypothesized that children with IBD have high exposure to radiation from medical imaging.
An Institutional Review Board (IRB)-approved retrospective chart review from 2002-2008 was performed on all patients with IBD. Radiographic studies performed were recorded and exposure for each study was estimated.
A total of 117 children with IBD (86 Crohn's disease [CD], 31 ulcerative colitis [UC]) were evaluated. The median current exposure was 15.1 mSv in CD and 7.2 mSv in UC (P = 0.005). Computed tomography (CT) scan and small bowel follow-through (SBFT) were responsible for 43% and 36% of all radiation exposures, respectively. The rate of radiation was higher in CD compared to UC (4.3 versus 2.2 mSv/yr). In CD, the rate of exposure was highest in the first 3 years of diagnosis (8.2 mSv/yr), and no different between the 3-5 year follow-up and 5+ year follow-up groups (3.8 versus 4.3 mSv/yr). Using the annual dose rate in those followed for more than 3 years, an estimated 47 out of 78 (60%) children (40 CD, 7 UC) would exceed 50 mSv by 35 years of age.
Radiation exposure from medical imaging is high in a subset of children diagnosed with IBD. Estimation of radiation exposure at age 35 suggests a significant portion of children with IBD will have high radiation exposure in their lifetime. Nonionizing imaging such as magnetic resonance imaging (MRI) and ultrasound should be offered to children with IBD as an alternative to current imaging that employs radiation.
患有炎症性肠病（IBD）的儿童会接受电离辐射成像检查，并可能受到高累积辐射。我们假设患有 IBD 的儿童受到的放射医学影像学检查辐射量很大。
对 2002 年至 2008 年间所有 IBD 患者进行了机构审查委员会（IRB）批准的回顾性图表审查。记录进行的影像学研究，并估计每项研究的暴露情况。
共评估了 117 名患有 IBD 的儿童（86 名克罗恩病 [CD]，31 名溃疡性结肠炎 [UC]）。CD 的当前中位数暴露量为 15.1 mSv，UC 为 7.2 mSv（P = 0.005）。计算机断层扫描（CT）扫描和小肠跟踪（SBFT）分别占所有辐射暴露的 43%和 36%。与 UC 相比，CD 的放射率更高（4.3 与 2.2 mSv/yr）。在 CD 中，在诊断后的前 3 年暴露率最高（8.2 mSv/yr），在 3-5 年随访和 5 年以上随访组之间没有差异（3.8 与 4.3 mSv/yr）。对于随访时间超过 3 年的患者，使用每年的剂量率，估计有 78 名儿童中的 47 名（40 名 CD，7 名 UC）将在 35 岁时超过 50 mSv。
在诊断为 IBD 的儿童中，一部分儿童的放射医学影像学检查辐射量很大。估计 35 岁时的辐射暴露量表明，很大一部分 IBD 儿童在其一生中会受到高辐射。应向患有 IBD 的儿童提供非电离成像，如磁共振成像（MRI）和超声，以替代目前使用辐射的影像学检查。
