Estay Camila, Simian Daniela, Lubascher Jaime, Figueroa Carolina, O'Brien Andrés, Quera Rodrigo
Academic Research Unit, Clínica las Condes, Santiago, Chile; Resident of Internal Medicine, Universidad de Los Andes, Santiago, Chile.
J Dig Dis. 2015 Feb;16(2):83-9. doi: 10.1111/1751-2980.12213.
Imaging techniques are accurate and reliable in diagnosing inflammatory bowel disease (IBD). However, the main disadvantage of computed tomography (CT) compared with magnetic resonance imaging (MRI) is radiation exposure and the potential risk of cancer, especially since IBD patients are at increased risk of malignancies. This study aims to quantify and characterize effective radiation exposure of IBD patients.
A cohort of IBD patients were retrospectively enrolled in the Clínica las Condes IBD registry between 2011 and 2013. High cumulative radiation exposure (CED) was defined as ≥-50 mSv.
A total of 325 IBD patients were enrolled in our registry, including 243 (74.8%) with UC and 82 (25.2%) with CD. The patients with CD were more commonly to reach a high CED seen compared with those with UC (19.5% vs 2.5%). Higher exposure to radiation was associated with longer duration of disease, ileal involvement, stricturing behavior, treatments with steroids and biological agents and CD-related hospitalization or surgery. Abdominopelvic CT and enteroclysis CT accounted for 93.6% of total CED.
A high percentage of IBD patients are exposed to high CED. Radiation-free cross-sectional examinations, such as MRI, should be used, especially in young patients, those who have undergone prior surgery and those with severe IBD.
成像技术在诊断炎症性肠病（IBD）方面准确可靠。然而，与磁共振成像（MRI）相比，计算机断层扫描（CT）的主要缺点是辐射暴露以及潜在的癌症风险，特别是因为IBD患者患恶性肿瘤的风险增加。本研究旨在量化并描述IBD患者的有效辐射暴露情况。
回顾性纳入2011年至2013年间在拉斯孔德斯诊所IBD登记处登记的一组IBD患者。高累积辐射暴露（CED）定义为≥-50 mSv。
我们的登记处共纳入325例IBD患者，其中243例（74.8%）为溃疡性结肠炎（UC）患者，82例（25.2%）为克罗恩病（CD）患者。与UC患者相比，CD患者更常出现高CED（19.5%对2.5%）。更高的辐射暴露与疾病持续时间更长、回肠受累、狭窄行为、使用类固醇和生物制剂治疗以及与CD相关的住院或手术有关。腹盆腔CT和小肠灌肠CT占总CED的93.6%。
高比例的IBD患者暴露于高CED。应使用无辐射的横断面检查，如MRI，尤其是在年轻患者、既往接受过手术的患者以及重度IBD患者中。
