Schooler Gary R, Cravero Joseph P, Callahan Michael J
Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA.
Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA.
Pediatr Radiol. 2022 Apr;52(4):616-621. doi: 10.1007/s00247-021-05138-0. Epub 2021 Jul 20.
Neonates represent a unique subset of the pediatric population that requires special attention and careful thought when implementing advanced cross-sectional imaging with CT or MRI. The ionizing radiation associated with CT and the sedation/anesthesia occasionally required for MRI present risks that must be balanced against the perceived benefit of the imaging examination in the unique and particularly susceptible neonatal population. We review the perceived risks of ionizing radiation and the more concrete risks of sedation/anesthesia in term and preterm neonates in the context of an imaging paradigm. When the expected diagnostic yield from CT and MRI is similar, and sedation is required for MRI but not for CT, CT likely has the higher benefit-to-risk ratio in the neonate. However, despite the risks, the most appropriate imaging modality should always be chosen after thoughtful consideration is given to each unique patient and informed discussions including radiology, anesthesia, neonatology and the parents/caregivers are pursued.
新生儿是儿科人群中的一个独特子集，在使用CT或MRI进行先进的横断面成像时，需要特别关注和谨慎考虑。与CT相关的电离辐射以及MRI偶尔需要的镇静/麻醉存在风险，必须在这个独特且特别易受影响的新生儿群体中，将这些风险与成像检查的预期益处进行权衡。我们在成像模式的背景下，回顾了足月儿和早产儿中电离辐射的感知风险以及镇静/麻醉更具体的风险。当CT和MRI的预期诊断率相似，且MRI需要镇静而CT不需要时，CT在新生儿中可能具有更高的效益风险比。然而，尽管存在风险，但在对每个独特患者进行深思熟虑的考虑并进行包括放射科、麻醉科、新生儿科以及父母/护理人员在内的知情讨论后，始终应选择最合适的成像方式。
