Vogel Elizabeth, Leaver Thomas, Wall Fiona, Johnson Ben, Uglow Michael, Aarvold Alexander
Southampton Medical School, Southampton University, Southampton, UK.
Medical Physics Department, University Hospital Southampton, Southampton, UK.
Indian J Orthop. 2021 Jun 30;55(6):1543-1548. doi: 10.1007/s43465-021-00438-x. eCollection 2020 Dec.
There are no data on the effect of X-Ray irradiation to the vulnerable pelvic organs of babies during DDH follow-up. This study aims to calculate, for the first time, the radiation exposure to infants during follow-up for DDH harness treatment, and thus quantify the lifetime risk of malignancy.
Patients who had completed 5 years' follow-up following successful Pavlik harness treatment were identified from the hospital DDH database. The radiation dose was extracted from the Computerised Radiology Information System database for every radiograph of every patient. The effective dose (ED) was calculated using conversion coefficients for age, sex and body region irradiated. Cumulative ED was compared to Health Protection Agency standards to calculate lifetime risk of malignancy from the radiographs.
All radiographs of 40 infants, successfully treated in Pavlik harness for DDH, were assessed. The mean number of AP pelvis radiographs was 7.00 (range: 6-9, mode: 7). The mean cumulative ED was 0.25 mSv (Range: 0.11-0.46, SD: 0.07). This is far lower than the 'safe' limit for healthcare workers of 20 mSv and is categorised as "Very Low Risk".
Clinicians involved in the treatment DDH can be re-assured that the cumulative radiation exposure from pelvic radiographs following Pavlik harness treatment is "Very Low Risk". Whilst being mindful of any radiation exposure in children, this study provides a scientific answer that help addresses parental concerns.
目前尚无关于发育性髋关节发育不良(DDH)随访期间X射线照射婴儿易受影响盆腔器官的影响的数据。本研究旨在首次计算DDH吊带治疗随访期间婴儿的辐射暴露量,从而量化终生患恶性肿瘤的风险。
从医院的DDH数据库中识别出成功接受 Pavlik 吊带治疗并完成5年随访的患者。从计算机放射信息系统数据库中提取每位患者每张X光片的辐射剂量。使用针对受照射年龄、性别和身体部位的转换系数计算有效剂量(ED)。将累积有效剂量与健康保护局的标准进行比较,以计算X光片导致的终生患恶性肿瘤风险。
对40例成功接受 Pavlik 吊带治疗DDH的婴儿的所有X光片进行了评估。前后位骨盆X光片的平均数量为7.00(范围:6 - 9,众数:7)。平均累积有效剂量为0.25 mSv(范围:0.11 - 0.46,标准差:0.07)。这远低于医护人员20 mSv的“安全”限值,被归类为“极低风险”。
参与DDH治疗的临床医生可以放心,Pavlik 吊带治疗后骨盆X光片的累积辐射暴露为“极低风险”。在关注儿童任何辐射暴露的同时,本研究提供了一个科学答案,有助于解决家长的担忧。