Dobson Gareth M, Dalton Arthur K, Nicholson Claire L, Jenkins Alistair J, Mitchell Patrick B, Cowie Christopher J A
Department of Neurosurgery, Great North Children's Hospital, Queen Victoria Road, Newcastle upon Tyne, UK.
Atkinson Morley Regional Neurosciences Centre, St George's Hospital, London, UK.
Childs Nerv Syst. 2020 Mar;36(3):591-599. doi: 10.1007/s00381-019-04345-3. Epub 2019 Aug 19.
A computed tomography (CT) scan in childhood is associated with a greater incidence of brain cancer. CT scans are used in patients with ventriculo-peritoneal (VP) shunts in whom shunt dysfunction is suspected. We wanted to assess the CT scan exposure in a cohort of children with VP shunts and attempt to quantify their radiation exposure.
A single-centre retrospective analysis was performed recording CT head scans in children younger than 18 years with VP shunts. Hospital coding data was cross-referenced with electronic records and radiology databases both in our neurosurgery unit and in hospitals referring to it.
One hundred and fifty-two children with VP shunts were identified. The mean time with shunt in situ was 5.4 years (± 4.61). A mean of 3.33 CT scans (range 0-20) were performed on each child, amounting to 0.65 (± 0.87) CTs per shunt year. Based on 2 msv of radiation per scan, this equates to an average exposure of 1.31 msv per child per shunt year.
Children who have multiple CT head scans for investigation of possible shunt dysfunction are at a greater risk of developing cancer. We discuss the implications of this increased risk and discuss strategies to limit radiation exposure in children with VP shunts.
儿童期的计算机断层扫描（CT）与患脑癌的几率增加相关。CT扫描用于怀疑存在脑室-腹腔（VP）分流功能障碍的患者。我们想要评估一组VP分流患儿的CT扫描暴露情况，并尝试对他们的辐射暴露进行量化。
进行了一项单中心回顾性分析，记录18岁以下患有VP分流的儿童的头部CT扫描情况。医院编码数据与我们神经外科科室及其转诊医院的电子记录和放射学数据库进行了交叉对照。
确定了152例患有VP分流的儿童。分流器原位放置的平均时间为5.4年（±4.61）。每个儿童平均进行了3.33次CT扫描（范围0 - 20次），相当于每个分流器每年0.65次（±0.87次）CT扫描。基于每次扫描2毫希沃特的辐射量，这相当于每个儿童每个分流器每年平均暴露于1.31毫希沃特的辐射。
因可能的分流功能障碍而接受多次头部CT扫描的儿童患癌症的风险更高。我们讨论了这种风险增加的影响，并探讨了限制VP分流患儿辐射暴露的策略。
