UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Childs Nerv Syst. 2021 Aug;37(8):2635-2641. doi: 10.1007/s00381-021-05254-0. Epub 2021 Jun 16.
The role of computed tomography (CT) for diagnosis and surgical planning for craniosynostosis (CS) is well-established. The aim of this study was to quantify the cumulative medical radiation exposure from CT in patients with CS at a tertiary care children's hospital.
Medical records of patients who presented at < 2 years of age and underwent surgical intervention for CS were examined for demographic information. Effective radiation dose (ERD) in mSv was calculated for each head CT. Descriptive statistics and ANOVA were performed. Mean ± SD is reported; p < 0.05 was considered significant.
Two hundred seventy-two patients met inclusion criteria: 241 nonsyndromic and 31 with syndromic diagnoses. For nonsyndromic patients, mean age at first head CT was 6.0 ± 4.9 months, mean number of CT scans obtained was 2.1 ± 1.1, and the mean total combined ERD was 9.1 ± 4.8 mSv. CT scans obtained at < 6 months of age had a significantly greater ERD than those obtained at > 6 months, 5.3 ± 1.9 versus 4.3 ± 1.4 mSv, respectively (p = 0.001).
Patients with nonsyndromic CS undergo 2 CT scans on average related to their diagnosis, with a mean total ERD of 9.1 mSv; this is equivalent to 1.5 years of the average annual background radiation dose a person living in the USA will encounter from environmental radiation, medical exposures, and consumer products. A CT obtained at < 6 months is associated with a higher ERD; thus, we recommend delaying imaging from the initial presentation to the time of pre-operative planning when possible.
计算机断层扫描（CT）在颅缝早闭（CS）的诊断和手术规划中的作用已得到充分证实。本研究的目的是量化一家三级儿童保健医院 CS 患者的 CT 累计医疗辐射暴露量。
检查了在<2 岁时就诊并接受 CS 手术干预的患者的病历，以获取人口统计学信息。以毫西弗（mSv）为单位计算每个头部 CT 的有效辐射剂量（ERD）。进行了描述性统计和 ANOVA 分析。报告平均值±标准差；p<0.05 被认为具有统计学意义。
符合纳入标准的 272 例患者：241 例非综合征型和 31 例综合征型。对于非综合征型患者，首次头部 CT 的平均年龄为 6.0±4.9 个月，平均获取的 CT 扫描次数为 2.1±1.1，总累计 ERD 平均为 9.1±4.8 mSv。<6 个月龄时获取的 CT 扫描的 ERD 明显高于>6 个月龄时获取的 CT 扫描，分别为 5.3±1.9 和 4.3±1.4 mSv（p=0.001）。
非综合征型 CS 患者平均接受 2 次与诊断相关的 CT 扫描，总平均 ERD 为 9.1 mSv；这相当于一个人在美国生活中每年因环境辐射、医疗暴露和消费产品而接触到的平均背景辐射剂量的 1.5 年。<6 个月龄时获取的 CT 扫描与更高的 ERD 相关；因此，我们建议在可能的情况下，从初始就诊到术前规划阶段延迟影像学检查。
