Kaynar Mehmet, Tekinarslan Erdem, Keskin Suat, Buldu İbrahim, Sönmez Mehmet Giray, Karatag Tuna, Istanbulluoglu Mustafa Okan
Department of Urology, Selcuk University, Faculty of Medicine, Konya, Turkey.
Department of Urology, Konya Education and Research Hospital, Konya, Turkey.
Cent European J Urol. 2015;68(3):348-52. doi: 10.5173/ceju.2015.547. Epub 2015 Sep 26.
To determine and evaluate the effective radiation exposure during a one year follow-up of urolithiasis patients following the SWL (extracorporeal shock wave lithotripsy) treatment.
Total Effective Radiation Exposure (ERE) doses for each of the 129 patients: 44 kidney stone patients, 41 ureter stone patients, and 44 multiple stone location patients were calculated by adding up the radiation doses of each ionizing radiation session including images (IVU, KUB, CT) throughout a one year follow-up period following the SWL.
Total mean ERE values for the kidney stone group was calculated as 15, 91 mSv (5.10-27.60), for the ureter group as 13.32 mSv (5.10-24.70), and in the multiple stone location group as 27.02 mSv (9.41-54.85). There was no statistically significant differences between the kidney and ureter groups in terms of the ERE dose values (p = 0.221) (p >0.05). In the comparison of the kidney and ureter stone groups with the multiple stone location group; however, there was a statistically significant difference (p = 0.000) (p <0.05).
ERE doses should be a factor to be considered right at the initiation of any diagnostic and/or therapeutic procedure. Especially in the case of multiple stone locations, due to the high exposure to ionized radiation, different imaging modalities with low dose and/or totally without a dose should be employed in the diagnosis, treatment, and follow-up bearing the aim to optimize diagnosis while minimizing the radiation dose as much as possible.
确定并评估体外冲击波碎石术(SWL)治疗后的尿路结石患者在一年随访期间的有效辐射暴露情况。
对129例患者(44例肾结石患者、41例输尿管结石患者和44例多部位结石患者)分别计算其总有效辐射暴露(ERE)剂量,方法是将体外冲击波碎石术后一年随访期内每次电离辐射检查(包括静脉肾盂造影(IVU)、腹部平片(KUB)、计算机断层扫描(CT))的辐射剂量相加。
肾结石组的总平均ERE值计算为15.91 mSv(5.10 - 27.60),输尿管结石组为13.32 mSv(5.10 - 24.70),多部位结石组为27.02 mSv(9.41 - 54.85)。肾结石组和输尿管结石组在ERE剂量值方面无统计学显著差异(p = 0.221)(p > 0.05)。然而,在将肾结石组和输尿管结石组与多部位结石组进行比较时,存在统计学显著差异(p = 0.000)(p < 0.05)。
在任何诊断和/或治疗程序开始时,ERE剂量都应作为一个需要考虑的因素。特别是对于多部位结石的情况,由于电离辐射暴露较高,在诊断、治疗和随访过程中应采用低剂量和/或完全无剂量的不同成像方式,目的是在优化诊断的同时尽可能减少辐射剂量。