儿童CT辐射暴露及防护进展
Advances in Radiation Exposure and Protection of CT in Children
DOI: 10.12677/acm.2025.151212, PDF,   
作者: 吴镕杰:赣南医科大学第一临床医学院,江西 赣州;刘 潜*:江西中医药大学中西医结合儿童健康研究院,江西 南昌
关键词: 儿童CT辐射暴露辐射防护Children CT Radiation Exposure Radiation Protection
摘要: 目的:了解儿童CT辐射暴露的影响以及CT防护的进展。方法:通过阅读文献,总结目前研究发现的儿童CT暴露的影响,以及减少CT辐射的探索。结论:儿童CT辐射暴露后受到影响较成年人更大,患癌风险增加,必须引起重视,常用的方法包括选择可替代的检查来减少CT次数,或在使用CT时,使用防护装置,添加预过滤器,调整CT暴露参数,建立儿童诊断参考水平,应用新型后处理技术、AI技术,研究使用新型设备,这些方法都能有效减少CT辐射暴露,从而降低对儿童的长期影响。
Abstract: Objective: To investigate the effects of CT radiation exposure in children and the progress of CT protection. Methods: By reading the literature, we summarized the effects of current studies on children’s CT exposure and explored ways to reduce CT radiation. Conclusion: Children are more affected by CT radiation exposure than adults and have an increased risk of cancer, which must be paid attention to. Common methods include choosing alternative examinations to reduce the number of CT scans, or using protective devices when using CT, adding pre-filters, adjusting CT exposure parameters, establishing diagnostic reference levels for children, applying new post-processing technologies and AI technologies. Using new equipment, these methods are effective in reducing CT radiation exposure, thereby reducing the long-term effects on children.
文章引用:吴镕杰, 刘潜. 儿童CT辐射暴露及防护进展[J]. 临床医学进展, 2025, 15(1): 1581-1587. https://doi.org/10.12677/acm.2025.151212

参考文献

[1] Chen, J. (2024) A Summary of UNSCEAR Evaluation on Medical Exposure to Ionizing Radiation and Call for More Representative Data. Radiation Medicine and Protection, 5, 7-10. [Google Scholar] [CrossRef
[2] Miglioretti, D.L., Johnson, E., Williams, A., Greenlee, R.T., Weinmann, S., Solberg, L.I., et al. (2013) The Use of Computed Tomography in Pediatrics and the Associated Radiation Exposure and Estimated Cancer Risk. JAMA Pediatrics, 167, 700-707. [Google Scholar] [CrossRef] [PubMed]
[3] Meulepas, J.M., Smets, A.M.J.B., Nievelstein, R.A.J., Gradowska, P., Verbeke, J., Holscher, H.C., et al. (2016) Trends and Patterns of Computed Tomography Scan Use among Children in the Netherlands: 1990-2012. European Radiology, 27, 2426-2433. [Google Scholar] [CrossRef] [PubMed]
[4] Vaughan, C.L. and Mayosi, B.M. (2007) Origins of Computed Tomography. The Lancet, 369, 1168. [Google Scholar] [CrossRef] [PubMed]
[5] Mathews, J.D., Forsythe, A.V., Brady, Z., Butler, M.W., Goergen, S.K., Byrnes, G.B., et al. (2013) Cancer Risk in 680,000 People Exposed to Computed Tomography Scans in Childhood or Adolescence: Data Linkage Study of 11 Million Australians. BMJ, 346, f2360-f2360. [Google Scholar] [CrossRef] [PubMed]
[6] Pearce, M.S., Salotti, J.A., Little, M.P., McHugh, K., Lee, C., Kim, K.P., et al. (2012) Radiation Exposure from CT Scans in Childhood and Subsequent Risk of Leukaemia and Brain Tumours: A Retrospective Cohort Study. The Lancet, 380, 499-505. [Google Scholar] [CrossRef] [PubMed]
[7] Li, I., Yang, Y., Li, Y. and Tsai, Y. (2020) Paediatric Computed Tomography and Subsequent Risk of Leukaemia, Intracranial Malignancy and Lymphoma: A Nationwide Population-Based Cohort Study. Scientific Reports, 10, Article No. 7759. [Google Scholar] [CrossRef] [PubMed]
[8] Liu, D., Wu, J., Chen, S., Liu, Y., Zhang, G., Ping, H., et al. (2019) Ultrasonography Can Replace CT Scans as the Initial Imaging Examination of Ureteral Calculi. Urologia Internationalis, 103, 68-73. [Google Scholar] [CrossRef] [PubMed]
[9] De Luca, F., Kits, A., Martin Muñoz, D., Aspelin, Å., Kvist, O., Österman, Y., et al. (2024) Elective One-Minute Full Brain Multi-Contrast MRI versus Brain CT in Pediatric Patients: A Prospective Feasibility Study. BMC Medical Imaging, 24, Article No. 23. [Google Scholar] [CrossRef] [PubMed]
[10] Cicogna, A., Minca, G., Posocco, F., Corno, F., Basile, C., Da Dalt, L., et al. (2022) Non-Ionizing Imaging for the Emergency Department Assessment of Pediatric Minor Head Trauma. Frontiers in Pediatrics, 10, Article 881461. [Google Scholar] [CrossRef] [PubMed]
[11] Kim, D., Jeon, P., Lee, C. and Chung, M. (2023) Effect of Tube Voltage and Radiation Dose on Image Quality in Pediatric Abdominal CT Using Deep Learning Reconstruction: A Phantom Study. Symmetry, 15, Article 501. [Google Scholar] [CrossRef
[12] Yoshida, K., Nagayama, Y., Funama, Y., Ishiuchi, S., Motohara, T., Masuda, T., et al. (2024) Low Tube Voltage and Deep-Learning Reconstruction for Reducing Radiation and Contrast Medium Doses in Thin-Slice Abdominal CT: A Prospective Clinical Trial. European Radiology, 34, 7386-7396. [Google Scholar] [CrossRef] [PubMed]
[13] Papadakis, A.E. and Damilakis, J. (2019) Automatic Tube Current Modulation and Tube Voltage Selection in Pediatric Computed Tomography: A Phantom Study on Radiation Dose and Image Quality. Investigative Radiology, 54, 265-272. [Google Scholar] [CrossRef] [PubMed]
[14] Leyendecker, P., Faucher, V., Labani, A., Noblet, V., Lefebvre, F., Magotteaux, P., et al. (2018) Prospective Evaluation of Ultra-Low-Dose Contrast-Enhanced 100-Kv Abdominal Computed Tomography with Tin Filter: Effect on Radiation Dose Reduction and Image Quality with a Third-Generation Dual-Source CT System. European Radiology, 29, 2107-2116. [Google Scholar] [CrossRef] [PubMed]
[15] Weis, M., Henzler, T., Nance, J.W., Haubenreisser, H., Meyer, M., Sudarski, S., et al. (2017) Radiation Dose Comparison between 70 kVp and 100 kVp with Spectral Beam Shaping for Non-Contrast-Enhanced Pediatric Chest Computed Tomography: A Prospective Randomized Controlled Study. Investigative Radiology, 52, 155-162. [Google Scholar] [CrossRef] [PubMed]
[16] Mozaffary, A., Trabzonlu, T.A., Kim, D. and Yaghmai, V. (2019) Comparison of Tin Filter-Based Spectral Shaping CT and Low-Dose Protocol for Detection of Urinary Calculi. American Journal of Roentgenology, 212, 808-814. [Google Scholar] [CrossRef] [PubMed]
[17] Steidel, J., Maier, J., Sawall, S. and Kachelrieß, M. (2021) Dose Reduction Potential in Diagnostic Single Energy CT through Patient‐Specific Prefilters and a Wider Range of Tube Voltages. Medical Physics, 49, 93-106. [Google Scholar] [CrossRef] [PubMed]
[18] Greffier, J., Pereira, F., Hamard, A., Addala, T., Beregi, J.P. and Frandon, J. (2020) Effect of Tin Filter-Based Spectral Shaping CT on Image Quality and Radiation Dose for Routine Use on Ultralow-Dose CT Protocols: A Phantom Study. Diagnostic and Interventional Imaging, 101, 373-381. [Google Scholar] [CrossRef] [PubMed]
[19] 高通, 王小山, 马娅, 等. 儿童CT检查诊断参考水平研究进展[J]. 中国辐射卫生, 2024, 33(2): 215-220.
[20] Satharasinghe, D., Jeyasugiththan, J., Wanninayake, W.M.N.M.B., Pallewatte, A.S. and Samarasinghe, R.A.N.K.K. (2022) Patient Size as a Parameter for Determining Diagnostic Reference Levels for Paediatric Computed Tomography (CT) Procedures. Physica Medica, 102, 55-65. [Google Scholar] [CrossRef] [PubMed]
[21] Muhammad, N.A., Abdul Karim, M.K., Abu Hassan, H., Ahmad Kamarudin, M., Ding Wong, J.H. and Ng, K.H. (2020) Diagnostic Reference Level of Radiation Dose and Image Quality among Paediatric CT Examinations in a Tertiary Hospital in Malaysia. Diagnostics, 10, Article 591. [Google Scholar] [CrossRef] [PubMed]
[22] 中华医学会儿科学分会影像学组, 中华医学会放射学分会儿科学组, 彭芸, 等. 儿童CT检查辐射剂量标准中国专家共识[J]. 中华放射学杂志, 2024, 58(2): 158-164.
[23] Sun, J., Yang, L., Zhou, Z., Zhang, D., Han, W., Zhang, Q., et al. (2020) Performance Evaluation of Two Iterative Reconstruction Algorithms, MBIR and ASIR, in Low Radiation Dose and Low Contrast Dose Abdominal CT in Children. La Radiologia Medica, 125, 918-925. [Google Scholar] [CrossRef] [PubMed]
[24] Zhang, K., Shi, X., Xie, S., Sun, J., Liu, Z., Zhang, S., et al. (2022) Deep Learning Image Reconstruction in Pediatric Abdominal and Chest Computed Tomography: A Comparison of Image Quality and Radiation Dose. Quantitative Imaging in Medicine and Surgery, 12, 3238-3250. [Google Scholar] [CrossRef] [PubMed]
[25] Brady, S.L., Trout, A.T., Somasundaram, E., Anton, C.G., Li, Y. and Dillman, J.R. (2021) Improving Image Quality and Reducing Radiation Dose for Pediatric CT by Using Deep Learning Reconstruction. Radiology, 298, 180-188. [Google Scholar] [CrossRef] [PubMed]
[26] Nagayama, Y., Sakabe, D., Goto, M., Emoto, T., Oda, S., Nakaura, T., et al. (2021) Deep Learning-Based Reconstruction for Lower-Dose Pediatric CT: Technical Principles, Image Characteristics, and Clinical Implementations. RadioGraphics, 41, 1936-1953. [Google Scholar] [CrossRef] [PubMed]
[27] Zhang, Z. and Seeram, E. (2020) The Use of Artificial Intelligence in Computed Tomography Image Reconstruction—A Literature Review. Journal of Medical Imaging and Radiation Sciences, 51, 671-677. [Google Scholar] [CrossRef] [PubMed]
[28] El-Ali, A.M., Strubel, N., Pinkney, L., Xue, C., Dane, B. and Lala, S.V. (2024) Pediatric Contrast-Enhanced Chest CT on a Photon-Counting Detector CT: Radiation Dose and Image Quality Compared to Energy-Integrated Detector CT. Pediatric Radiology, 54, 1984-1995. [Google Scholar] [CrossRef] [PubMed]
[29] Lee, J.S., Kim, J., Bapuraj, J.R. and Srinivasan, A. (2024) Comparison of Image Quality and Radiation Dose in Pediatric Temporal Bone CT Using Photon-Counting Detector CT and Energy-Integrating Detector CT. American Journal of Neuroradiology, 45, 1322-1326. [Google Scholar] [CrossRef] [PubMed]
[30] Mese, I., Altintas Mese, C., Demirsoy, U. and Anik, Y. (2023) Innovative Advances in Pediatric Radiology: Computed Tomography Reconstruction Techniques, Photon-Counting Detector Computed Tomography, and Beyond. Pediatric Radiology, 54, 1-11. [Google Scholar] [CrossRef] [PubMed]
[31] Higashigaito, K., Mergen, V., Eberhard, M., Jungblut, L., Hebeisen, M., Rätzer, S., et al. (2023) CT Angiography of the Aorta Using Photon-Counting Detector CT with Reduced Contrast Media Volume. Radiology: Cardiothoracic Imaging, 5, e220140. [Google Scholar] [CrossRef] [PubMed]