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儿童炎症性肠病的辐射暴露。

Radiation exposure in children with inflammatory bowel disease.

机构信息

Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia 30322, USA.

出版信息

Curr Opin Pediatr. 2012 Oct;24(5):621-6. doi: 10.1097/MOP.0b013e32835742a2.

Abstract

PURPOSE OF REVIEW

Radiation exposure due to medical imaging has grown exponentially over the past two decades and the awareness has increased in the last few years with a number of articles in scientific publications and lay press. Radiation increases the risk of cancer and is particularly a concern in children. Limiting radiation exposure is most important in children, who are more sensitive to radiation, and specifically in children with a chronic lifelong disease such as inflammatory bowel disease (IBD).

RECENT FINDINGS

Children with IBD and specifically Crohn's disease demonstrate high exposure to ionizing radiation due to medical imaging. The yearly rate of medical imaging radiation exposure may seem small at approximately 3-5 mSv/year, which is only slightly higher than typical background radiation (3 mSv/year). However, this extra yearly radiation exposure to children with a lifelong chronic disease may increase the risk of cancer. Additionally, recent literature suggests that some children with more severe disease are exposed to high radiation doses within the first few years of diagnosis. Imaging modalities that do not utilize radiation, such as MRI and ultrasonography, have demonstrated utility in diagnosing and managing IBD and are particularly important for children.

SUMMARY

Pediatricians caring for children with chronic diseases should consider radiation exposure and limit exposure when possible. Future quality outcome benchmarks should include limiting exposure to radiation in children with chronic diseases.

摘要

目的综述

在过去的二十年中,由于医学成像导致的辐射暴露呈指数级增长,近年来,随着科学出版物和大众媒体上的大量文章的出现,人们对这一问题的认识有所提高。辐射会增加癌症的风险,尤其在儿童中更为令人关注。限制辐射暴露在儿童中最为重要,因为儿童对辐射更敏感,特别是患有慢性终身疾病(如炎症性肠病)的儿童。

最新发现

由于医学影像学检查,患有 IBD 特别是克罗恩病的儿童受到大量电离辐射。每年的医学影像学辐射暴露率似乎很小,约为 3-5mSv/年,仅略高于典型的背景辐射(3mSv/年)。然而,对于患有终身慢性疾病的儿童来说,这种额外的每年辐射暴露可能会增加癌症的风险。此外,最近的文献表明,一些病情更严重的儿童在诊断后的头几年内暴露于高剂量辐射。不利用辐射的成像方式,如 MRI 和超声检查,已被证明在诊断和管理 IBD 方面具有实用性,对于儿童尤为重要。

总结

照顾患有慢性疾病的儿童的儿科医生应考虑辐射暴露问题,并尽可能限制其暴露。未来的质量结果基准应包括限制患有慢性疾病的儿童的辐射暴露。

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