Journy Neige M, McHugh Kieran, Harbron Richard W, Pearce Mark S, Berrington De Gonzalez Amy
1 Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), Bethesda, MD, USA.
2 Great Ormond Street Hospital for Children, London, UK.
Br J Radiol. 2016 Dec;89(1068):20160532. doi: 10.1259/bjr.20160532. Epub 2016 Oct 21.
To describe the medical conditions associated with the use of CT in children or young adults with no previous cancer diagnosis.
Radiologist reports for scans performed in 1995-2008 in non-cancer patients less than 22 years of age were collected from the radiology information system in 44 hospitals of Great Britain. By semantic search, an automated procedure identified 185 medical conditions within the radiologist reports. Manual validation of a subsample by a paediatric radiologist showed a satisfactory performance of the automatic coding procedure.
Medical information was extracted for 37,807 scans; 19.5% scans were performed in children less than 5 years old; 52.0% scans were performed in 2000 or after. Trauma, diseases of the nervous (mainly hydrocephalus) or the circulatory system were each mentioned in 25-30% of scans. Hydrocephalus was mentioned in 19% of all scans, 59% of scans repeated ≥5 times in a year, and was the most frequent condition in children less than 5 years of age. Congenital diseases/malformations, disorders of the musculoskeletal system/connective tissues and infectious or respiratory diseases were each mentioned in 5-10% of scans. Suspicionor diagnosis of benign or malignant tumour was identified in 5% of scans.
This study describes the medical conditions that likely underlie the use of CT in children in Great Britain. It shows that patients with hydrocephalus may receive high cumulative radiation exposures from CT in early life, i.e. at ages when they are most sensitive to radiation. Advances in knowledge: The majority of scans were unrelated to cancer suspicion. Repeated scans over time were mainly associated with the management of hydrocephalus.
描述在既往无癌症诊断的儿童或青年中使用CT相关的医疗状况。
从英国44家医院的放射学信息系统中收集1995年至2008年对年龄小于22岁的非癌症患者进行扫描的放射科报告。通过语义搜索，一个自动化程序在放射科报告中识别出185种医疗状况。一名儿科放射科医生对一个子样本进行人工验证，结果显示自动编码程序的表现令人满意。
提取了37807次扫描的医疗信息；19.5%的扫描是对小于5岁的儿童进行的；52.0%的扫描是在2000年或之后进行的。创伤、神经（主要是脑积水）或循环系统疾病在25%至30%的扫描报告中均有提及。脑积水在所有扫描报告中的提及率为19%，在一年内重复≥5次的扫描报告中的提及率为59%，并且是小于5岁儿童中最常见的状况。先天性疾病/畸形、肌肉骨骼系统/结缔组织疾病以及感染性或呼吸道疾病在5%至10%的扫描报告中均有提及。在5%的扫描报告中发现了良性或恶性肿瘤的疑似或诊断。
本研究描述了英国儿童使用CT可能的潜在医疗状况。研究表明，脑积水患者在生命早期即对辐射最敏感的年龄段可能因CT而受到高累积辐射暴露。知识进展：大多数扫描与癌症疑似无关。随着时间推移的重复扫描主要与脑积水的管理有关。
