Waldman J D, Kaplan G W, Rummerfield P S, Gilpin E A, Kirkpatrick S E
Pediatr Cardiol. 1982;3(1):19-22. doi: 10.1007/BF02082325.
Postangiography urography has become routine procedure in most centers performing cardiac catheterization in children. We analyzed the x-radiation dosage and clinical yield of this procedure. Using lithium fluoride thermoluminescent dosimeters, radiation exposure to the abdomen and gonads was measured in 35 children during postangiography urography. Results of 334 consecutive routine postangiography cine-urograms were evaluated based on clinical significance and compared to previous reports on this subject. Average absorbed abdominal radiation dosage was 241 mR +/- 240 from cine-urography, 16 mR +/- 13 from fluoroscopy, and 107 mR +/- 111 from a single abdominal roentgenogram. Gonadal dosage averaged 8 mR and was uniformly less than 27 mR. Of 334 routine postangiography cineurograms, 282 (84%) were normal, 30 (9%) were technically inadequate, 12 (3%) had abnormalities that were clinically insignificant or were falsely "positive" and in 10 (3%), clinically significant urologic conditions were confirmed. Because of the low yield of clinically significant anomalies and the added radiation exposure, we no longer perform routine postangiography cine-urography in children. Following cardiac angiography, the upper renal collecting systems are examined fluoroscopically. If abnormalities are suspected or fluoroscopy is equivocal, a single abdominal roentgenogram is performed. Using this procedure, mean average absorbed abdominal radiation dose can be reduced from 241 mR to 30.5 mR.
血管造影术后尿路造影已成为大多数为儿童进行心导管插入术的中心的常规操作。我们分析了该操作的X线辐射剂量和临床收益。使用氟化锂热释光剂量计，在35名儿童进行血管造影术后尿路造影时测量了腹部和性腺的辐射暴露量。基于临床意义对334例连续的常规血管造影术后电影尿路造影片结果进行了评估，并与此前关于该主题的报告进行了比较。电影尿路造影的平均腹部吸收辐射剂量为241 mR±240，透视为16 mR±13，单次腹部X线平片为107 mR±111。性腺剂量平均为8 mR，均低于27 mR。在334例常规血管造影术后电影尿路造影片中，282例（84%）正常，30例（9%）技术上不充分，12例（3%）有临床意义不显著或为假“阳性”的异常，10例（3%）确诊有临床意义的泌尿系统疾病。由于有临床意义的异常检出率低且增加了辐射暴露，我们不再对儿童进行常规血管造影术后电影尿路造影。心脏血管造影术后，通过透视检查上肾集合系统。如果怀疑有异常或透视结果不明确，则进行单次腹部X线平片检查。采用该操作，腹部平均吸收辐射剂量可从241 mR降至30.5 mR。
