Gastroenterology Division, Centre Hospitalier de l'Université de Montréal, Quebec, Canada.
Health Physicist, Centre Hospitalier de l'Université de Montréal, Canada.
Can J Gastroenterol Hepatol. 2019 Jun 11;2019:2030735. doi: 10.1155/2019/2030735. eCollection 2019.
Because of the chronic and relapsing nature of inflammatory bowel disease (IBD), which often requires characterization with CT scan, IBD patients might be exposed to a large amount of radiation. As a cumulative effective dose (CED) ≥ 100 mSv is considered significant for stochastic risks of cancer, it is important to monitor and control the radiation exposure of the IBD patients. In the present work, we aimed to quantify the mean CED in IBD patients to assess any harmful effects of radiation.
This study includes 200 IBD patients, identified retrospectively, from the outpatient clinics of the Centre Hospitalier de l'Université de Montréal between January 1, 2010, and February 15, 2017, from the gastroenterologists' patients lists. The number and type of each radiology test performed were listed for each patient during the study period and the CED was calculated using our institution's dose index when available and standardized tables.
Among the 200 IBD patients, 157 patients had Crohn's disease (CD), 41 had ulcerative colitis (UC), and 2 had indeterminate colitis. The mean CED for IBD patients was 23.1 ± 45.2 mSv during a mean follow-up duration of 4.3 years. CED was higher among patients with CD than with UC (27.5 ± 49.5 versus 6.8 ± 14.8 mSv; p<0.01). Six patients were exposed to a high CED (>100 mSv) and all had CD.
While potentially harmful levels of radiation exposure are of concern in only a small number of patients, strategies to limit such exposure are encouraged when clinically appropriate.
由于炎症性肠病（IBD）具有慢性和复发性的特点，通常需要 CT 扫描进行特征描述，因此 IBD 患者可能会受到大量辐射。由于累积有效剂量（CED）≥100mSv 被认为与癌症的随机风险有关，因此监测和控制 IBD 患者的辐射暴露非常重要。在本研究中，我们旨在量化 IBD 患者的平均 CED，以评估辐射的任何有害影响。
本研究包括 200 名 IBD 患者，这些患者是从 2010 年 1 月 1 日至 2017 年 2 月 15 日期间在蒙特利尔大学医疗中心的门诊诊所，从胃肠病学家的患者名单中回顾性确定的。在研究期间，列出了每位患者每次放射学检查的数量和类型，并使用我们机构的剂量指数（如可用）和标准化表格计算 CED。
在 200 名 IBD 患者中，157 名患有克罗恩病（CD），41 名患有溃疡性结肠炎（UC），2 名患有不确定结肠炎。在平均 4.3 年的随访期间，IBD 患者的平均 CED 为 23.1±45.2mSv。CD 患者的 CED 高于 UC 患者（27.5±49.5 与 6.8±14.8mSv；p<0.01）。有 6 名患者暴露于高 CED（>100mSv），且均患有 CD。
尽管只有少数患者存在潜在有害水平的辐射暴露问题，但在临床适当的情况下，鼓励采取策略限制这种暴露。
