Choi Seung Joon, Kim Eun Young, Kim Hyung Sik, Choi Hye-Young, Cho Jinseong, Yang Hyuk Jun, Chung Yong Eun
From the Departments of *Radiology and †Emergency Medicine, Gachon University Gil Hospital, Incheon; and ‡Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Pediatr Emerg Care. 2014 Jul;30(7):479-82. doi: 10.1097/PEC.0000000000000165.
The aims of this study were to analyze cumulative effective dose (cED) and to assess lifetime attributable risk (LAR) of cancer due to radiation exposure during computed tomography (CT) examinations in adolescent trauma patients.
Between January 2010 and May 2011, the adolescent patients with trauma were enrolled in this study. Numbers of CT examinations and body regions examined were collated, and cEDs were calculated using dose-length product values and conversion factors. Lifetime attributable risk for cancer incidence and cancer-associated mortality were quantified based on the studies of survivors of the atomic bombs on Japan. Data were stratified according to severity of trauma: minor trauma, injury severity score of less than 16; and major trauma, injury severity score of 16 or greater.
A total of 698 CT scans were obtained on the following regions of 484 adolescent patients: head CT, n = 647; rest of the body, n = 41; and thorax, n = 10. Mean cED per patient was 3.4 mSv, and mean LARs for cancer incidence and mortality were 0.05% and 0.02%, respectively. The majority of patients (98.4%) experienced minor trauma, and their mean cED and LARs for cancer incidence and mortality (3.0 mSv and 0.04% and 0.02%, respectively) were significantly lower than those of patients with major trauma (24.3 mSv and 0.31% and 0.15%, respectively, all P values < 0.001).
The overall radiation-induced cancer risk due to CT examinations performed for the initial assessment of minor trauma was found to be relatively low in adolescent patients. However, adolescent patients with major trauma were exposed to a substantial amount of radiation during multiple CT examinations.
本研究旨在分析青少年创伤患者在计算机断层扫描（CT）检查期间的累积有效剂量（cED），并评估辐射暴露导致癌症的终生归因风险（LAR）。
2010年1月至2011年5月，纳入青少年创伤患者进行本研究。整理CT检查次数和检查的身体部位，并使用剂量长度乘积值和转换因子计算cED。基于对日本原子弹幸存者的研究，对癌症发病率和癌症相关死亡率的终生归因风险进行量化。根据创伤严重程度进行分层：轻度创伤，损伤严重程度评分小于16；重度创伤，损伤严重程度评分16或更高。
共对484例青少年患者的以下身体部位进行了698次CT扫描：头部CT，n = 647；身体其他部位，n = 41；胸部，n = 10。每位患者的平均cED为3.4 mSv，癌症发病率和死亡率的平均LAR分别为0.05%和0.02%。大多数患者（98.4%）经历轻度创伤，他们癌症发病率和死亡率的平均cED和LAR（分别为3.0 mSv、0.04%和0.02%）显著低于重度创伤患者（分别为24.3 mSv、0.31%和0.15%，所有P值<0.001）。
在青少年患者中，因对轻度创伤进行初始评估而进行的CT检查所导致的总体辐射诱发癌症风险相对较低。然而，重度创伤的青少年患者在多次CT检查期间受到了大量辐射。
