Abuhamed Jad, Nikkilä Atte, Lohi Olli, Auvinen Anssi
Faculty of Social Sciences, Tampere University, Tampere, Finland.
STUK - Radiation and Nuclear Safety Authority, Helsinki, Finland.
Eur J Radiol Open. 2020 Dec 9;7:100290. doi: 10.1016/j.ejro.2020.100290. eCollection 2020.
CT is an essential diagnostic tool in health care. However, CT delivers relatively high levels of radiation which has been associated with an increased risk of childhood cancer. To address this, we evaluated patterns and time trends of CT use among children in Finland during the period in which changes in pediatric CT imaging practices were reported in several countries.
Data on CTs performed on children younger than 15 years were obtained from Finland's largest eight hospitals. CT data included the period 1996-2010 with an estimated coverage of more than 80 % of pediatric CT imaging in Finland. Joinpoint regression was used for trends analysis. CT radiation doses were estimated based on a Finnish dosimetry survey.
A total of 48,807 pediatric CTs were performed in 1996-2010. More boys (55.5 %) were scanned than girls (42.8 %). CT numbers increased up to 2002, then decreased significantly (-6.9 % per year, 95 % CI: -10.4 to -3.2) towards 2005 and to a lesser extent thereafter, particularly among younger children. All CT types decreased in recent years, except for chest, spine, and extremities. The frequency of head CTs related to the diagnoses of intracranial injury, migraine and headache decreased towards the end of the study period. The estimated annual average effective dose from the three most common CT examinations was 0.004 mSv per child in the population.
The frequency of pediatric CTs in Finland started to decrease after 2002. Apart from chest and orthopedic CTs, the utilization of pediatric CT imaging declined in recent years, most likely explained by improved awareness of medical radiation risks and reliance on alternative modalities such as MRI and ultrasound.
CT是医疗保健中一项重要的诊断工具。然而，CT会产生相对较高水平的辐射，这与儿童患癌风险增加有关。为解决这一问题，我们评估了芬兰儿童CT使用的模式和时间趋势，此期间多个国家报告了儿科CT成像实践的变化。
从芬兰最大的八家医院获取了15岁以下儿童的CT数据。CT数据涵盖1996 - 2010年期间，估计覆盖了芬兰超过80%的儿科CT成像。采用连接点回归进行趋势分析。基于芬兰剂量学调查估算CT辐射剂量。
1996 - 2010年共进行了48,807次儿科CT检查。接受扫描的男孩（55.5%）多于女孩（42.8%）。CT检查数量在2002年之前增加，然后在2005年显著下降（每年-6.9%，95%CI：-10.4至-3.2），此后下降幅度较小，尤其是在年幼儿童中。近年来，除胸部、脊柱和四肢CT外，所有CT类型的检查数量均有所下降。在研究期末，与颅内损伤、偏头痛和头痛诊断相关的头部CT检查频率下降。人群中三个最常见CT检查的估计年平均有效剂量为每个儿童0.004 mSv。
芬兰儿科CT检查的频率在2002年后开始下降。除胸部和骨科CT外，近年来儿科CT成像的使用有所下降，这很可能是由于对医疗辐射风险的认识提高以及对MRI和超声等替代检查方式的依赖。
