Mandiwanza Tafadzwa, Saidlear Colm, Caird John, Crimmins Darach
Department of Paediatric Neurosurgery, Children's University Hospital, Temple Street, Dublin 1, Republic of Ireland.
Department of Radiology, Children's University Hospital, Temple Street, Dublin 1, Republic of Ireland.
Childs Nerv Syst. 2013 Jul;29(7):1177-81. doi: 10.1007/s00381-013-2073-0. Epub 2013 Mar 21.
Over the years, there has been increasing awareness of the radiation doses from medical investigation and treatment modalities and the long-term effect of this radiation. In no other patient population is this more of an issue than in the paediatric population who are more radiosensitive and have a longer life span in which to express any negative effects of radiation. In children under the age of one, the anterior fontanelle is an acoustic window to intracranial structures allowing for the use of cranial ultrasound (CRUSS) instead of CT.
To determine the pattern of CT and Cranial ultrasound used in patients aged one or younger with shunt treated hydrocephalus.
A retrospective review of patients who had a shunt inserted before the age of one and their imaging. Effective radiation doses were calculated for those who had CT scans.
One hundred thirty-five patients were included with 227 CTs and 124 CRUSS conducted. In the follow-up period after shunt insertion, 92 patients had CTs while 14 were followed with CRUSS and 51 patients required a shunt revision before the age of one. The average effective radiation dose per scan was 2.76 mSv.
Children with an open fontanelle and shunt can be followed reliably with CRUSS in order to reduce their exposure to radiation.
多年来，人们越来越意识到医学检查和治疗方式所产生的辐射剂量以及这种辐射的长期影响。在所有患者群体中，这一问题在儿科人群中最为突出，因为他们对辐射更敏感，且有更长的寿命来表现辐射的任何负面影响。对于一岁以下的儿童，前囟门是观察颅内结构的声学窗口，这使得可以使用头颅超声（CRUSS）而非CT。
确定在一岁及以下接受分流治疗的脑积水患者中CT和头颅超声的使用模式。
对一岁前接受分流手术的患者及其影像学检查进行回顾性研究。为接受CT扫描的患者计算有效辐射剂量。
纳入135例患者，共进行了227次CT检查和124次头颅超声检查。在分流术后的随访期内，92例患者接受了CT检查，14例接受头颅超声检查，51例患者在一岁前需要进行分流修正手术。每次扫描的平均有效辐射剂量为2.76毫希沃特。
对于囟门未闭且接受分流治疗的儿童，可通过头颅超声进行可靠的随访，以减少其辐射暴露。
