Niemann Tilo, Nicolas Guillaume, Roser Hans W, Müller-Brand Jan, Bongartz Georg
Insights Imaging. 2010 Nov;1(5-6):361-372. doi: 10.1007/s13244-010-0043-6. Epub 2010 Oct 2.
To give a comprehensive overview of fetal doses reported in the literature when imaging the pregnant woman with suspected pulmonary embolism (PE). METHODS: A comprehensive literature search in the PubMed, MEDLINE and EMBASE databases yielded a total of 1,687 papers that were included in the analysis and have been analysed with regard to fetal dose in suspected PE radiological imaging strategies. RESULTS: Fetal dose in chest computed tomography (CT) ranges between 0.013 and 0.026 mGy in early and 0.06-0.1 mGy in late pregnancy compared with 99mTc-MAA perfusion scintigraphy with a fetal dose of 0.1-0.6 mGy in early and 0.6-0.8 mGy in late pregnancy. (99m)Tc-aerosol ventilation scintigraphy results in 0.1-0.3 mGy. However, there is concern about female breast irradiation in CT, which is higher than in scintigraphy. CT radiation risks for breast tissue remain unclear. CONCLUSION: Knowledge of dosimetry and radiation risks is crucial in the radiological work-up of suspected PE in pregnancy. It is reasonable to reserve scintigraphy for pregnant patients with normal chest radiography findings and no history of asthma or chronic lung disease. Performing CT applying dose reduction instead of scintigraphy will minimise fetal radiation dose and maximise the diagnostic value.
全面概述在对疑似肺栓塞（PE）的孕妇进行成像时文献中报道的胎儿剂量。方法：在PubMed、MEDLINE和EMBASE数据库中进行全面的文献检索，共获得1687篇论文纳入分析，并针对疑似PE的放射成像策略中的胎儿剂量进行了分析。结果：胸部计算机断层扫描（CT）在妊娠早期胎儿剂量范围为0.013至0.026毫西弗，妊娠晚期为0.06 - 0.1毫西弗；相比之下，99mTc - MAA灌注闪烁扫描在妊娠早期胎儿剂量为0.1至0.6毫西弗，妊娠晚期为0.6至0.8毫西弗。（99m）Tc - 气溶胶通气闪烁扫描的胎儿剂量为0.1至0.3毫西弗。然而，人们担心CT对女性乳房的辐射，其辐射高于闪烁扫描。CT对乳房组织的辐射风险仍不明确。结论：在对妊娠疑似PE进行放射检查时，剂量测定和辐射风险的知识至关重要。对于胸部X线摄影结果正常且无哮喘或慢性肺病病史的孕妇，保留闪烁扫描是合理的。采用降低剂量的CT检查而非闪烁扫描将使胎儿辐射剂量最小化并使诊断价值最大化。
