Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
Korean J Radiol. 2022 May;23(5):517-528. doi: 10.3348/kjr.2021.0596. Epub 2022 Jan 27.
Due to its excellent diagnostic performance, CT is the mainstay of diagnostic test in adults with suspected acute appendicitis in many countries. Although debatable, extensive epidemiological studies have suggested that CT radiation is carcinogenic, at least in children and adolescents. Setting aside the debate over the carcinogenic risk of CT radiation, the value of judicious use of CT radiation cannot be overstated for the diagnosis of appendicitis, considering that appendicitis is a very common disease, and that the vast majority of patients with suspected acute appendicitis are adolescents and young adults with average life expectancies. Given the accumulated evidence justifying the use of low-dose CT (LDCT) of only 2 mSv, there is no reasonable basis to insist on using radiation dose of multi-purpose abdominal CT for the diagnosis of appendicitis, particularly in adolescents and young adults. Published data strongly suggest that LDCT is comparable to conventional dose CT in terms of clinical outcomes and diagnostic performance. In this narrative review, we will discuss such evidence for reducing CT radiation in adolescents and young adults with suspected appendicitis.
由于其出色的诊断性能，在许多国家，CT 都是诊断成人疑似阑尾炎的主要手段。尽管存在争议，但广泛的流行病学研究表明 CT 辐射具有致癌性，至少在儿童和青少年中是如此。暂且不论 CT 辐射致癌的风险争论，就阑尾炎的诊断而言，明智地使用 CT 辐射的价值怎么强调都不过分，因为阑尾炎是一种非常常见的疾病，而且绝大多数疑似急性阑尾炎的患者都是平均预期寿命较长的青少年和年轻人。鉴于使用仅 2 毫希沃特的低剂量 CT（LDCT）的累积证据，没有合理的依据坚持使用多用途腹部 CT 的辐射剂量来诊断阑尾炎，特别是在青少年和年轻人中。已发表的数据强烈表明，在临床结果和诊断性能方面，LDCT 与常规剂量 CT 相当。在这篇叙述性综述中，我们将讨论在疑似阑尾炎的青少年和年轻人中减少 CT 辐射的相关证据。
