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冲击波碎石术(SWL)前儿童的放射学评估:他们受到多大程度的辐射?

Radiologic evaluation of children prior to SWL: to what extent they are exposed to radiation?

机构信息

Lutfi Kirdar Training and Research Hospital, Urology Clinic, Kartal, Istanbul, Turkey.

Lutfi Kirdar Training and Research Hospital, Radiology Clinic, Istanbul, Turkey.

出版信息

Urolithiasis. 2018 Oct;46(5):485-491. doi: 10.1007/s00240-017-1008-8. Epub 2017 Oct 26.

Abstract

The objective of this study is to evaluate the average radiation exposure in children with renal stones before SWL treatment. Mean radiation exposure values were evaluated in 110 children before SWL treatment. While some children referred to the emergency department (ED) with colic pain, remaining cases referred to outpatient department (OD). Although low-dose NCCT was performed in ED; KUB and abdominal sonography were first performed in other cases referring to OD where CT has been applied if needed. The type of imaging modality used and the mean radiation exposure were evaluated and comparatively evaluated with respect to the department referred, patient as well as stone related parameters. 49 children referred to ED and 61 children referred to OD. Mean stone size was 7.24 ± 0.29 mm. 62 cases had opaque stones. Mean radiation exposure values were higher in children referring to ED than the other cases. However, there was no significant difference between the two groups regarding the mean number of KUB, IVU and sonographic evaluation performed prior to SWL management. There was a significant correlation between the mean radiation exposure and the stone size as well degree of hydonephrosis in a positive manner. Although a significant correlation was present between the mean radiation exposure and stone opacity in a negative manner; there was no correlation with respect to the other related parameters. Unnecessary use of X-ray based imaging modalities in children could be effectively avoided using KUB and US combination beginning from the diagnostic phase of stone disease.

摘要

本研究旨在评估接受体外冲击波碎石术 (SWL) 治疗前儿童肾结石的平均辐射暴露量。在接受 SWL 治疗前,对 110 名儿童的平均辐射暴露值进行了评估。其中,一些儿童因绞痛就诊于急诊部 (ED),其余则就诊于门诊部 (OD)。尽管 ED 中进行了低剂量 NCCT,但在 OD 中首先进行了 KUB 和腹部超声检查,如果需要,再进行 CT 检查。评估了所使用的成像方式类型和平均辐射暴露量,并根据就诊科室、患者和结石相关参数进行了比较评估。49 名儿童就诊于 ED,61 名儿童就诊于 OD。平均结石大小为 7.24±0.29mm。62 例结石不透光。就诊于 ED 的儿童的平均辐射暴露值高于其他组。然而,两组在接受 SWL 治疗前进行的 KUB、IVU 和超声检查的平均次数方面没有显著差异。平均辐射暴露值与结石大小和肾积水程度呈正相关。虽然平均辐射暴露值与结石不透光性呈负相关,但与其他相关参数无相关性。通过从结石病的诊断阶段开始,结合 KUB 和 US 检查,可以有效地避免在儿童中不必要地使用 X 射线成像方式。

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