Picone Carmine, Fusco Roberta, Tonerini Michele, Fanni Salvatore Claudio, Neri Emanuele, Brunese Maria Chiara, Grassi Roberta, Danti Ginevra, Petrillo Antonella, Scaglione Mariano, Gandolfo Nicoletta, Giovagnoni Andrea, Barile Antonio, Miele Vittorio, Granata Claudio, Granata Vincenza
Division of Radiology, "Instituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli", 80131 Naples, Italy.
Medical Oncology Division, Igea SpA, 80013 Naples, Italy.
J Clin Med. 2023 Feb 25;12(5):1847. doi: 10.3390/jcm12051847.
In modern clinical practice, there is an increasing dependence on imaging techniques in several settings, and especially during emergencies. Consequently, there has been an increase in the frequency of imaging examinations and thus also an increased risk of radiation exposure. In this context, a critical phase is a woman's pregnancy management that requires a proper diagnostic assessment to reduce radiation risk to the fetus and mother. The risk is greatest during the first phases of pregnancy at the time of organogenesis. Therefore, the principles of radiation protection should guide the multidisciplinary team. Although diagnostic tools that do not employ ionizing radiation, such as ultrasound (US) and magnetic resonance imaging (MRI) should be preferred, in several settings as polytrauma, computed tomography (CT) nonetheless remains the examination to perform, beyond the fetus risk. In addition, protocol optimization, using dose-limiting protocols and avoiding multiple acquisitions, is a critical point that makes it possible to reduce risks. The purpose of this review is to provide a critical evaluation of emergency conditions, e.g., abdominal pain and trauma, considering the different diagnostic tools that should be used as study protocols in order to control the dose to the pregnant woman and fetus.
在现代临床实践中,在多种情况下,尤其是在急诊时,对成像技术的依赖日益增加。因此,成像检查的频率有所上升,辐射暴露风险也随之增加。在此背景下,一个关键阶段是孕妇的孕期管理,这需要进行恰当的诊断评估,以降低对胎儿和母亲的辐射风险。在器官形成期的妊娠早期,风险最大。因此,辐射防护原则应指导多学科团队。尽管应首选不使用电离辐射的诊断工具,如超声(US)和磁共振成像(MRI),但在多处创伤等多种情况下,计算机断层扫描(CT)尽管存在胎儿风险,仍是需要进行的检查。此外,优化方案,采用剂量限制方案并避免多次采集,是降低风险的关键所在。本综述的目的是对急诊情况,如腹痛和创伤,进行批判性评估,同时考虑应作为研究方案使用的不同诊断工具,以便控制对孕妇和胎儿的剂量。