[Patients with cerebrospinal fluid shunt: radiation during two years of follow-up]

Ionizing radiation due to diagnostic tests and treatment can contribute to the later development of cancer. The patients with cerebrospinal fluid shunts (CFS) are exposed to greater risk.

To estimate the cumulative radiation dose from radiological studies in children with CFS and to determine the potential factors associated with a high level of radiation.

Descriptive observational study. All children treated for hydrocephalus with a CFS between 2005 and 2006 were included. We registered the number of radiological examinations performed on these patients due to neurosurgical control or evaluation for possible shunt malfunction. The cumulative radiation dose from radiological studies was estimated for each patient.

Thirty-six patients were included. The median patient age was 6.1 months (range: 20 days - 15.3 years). One hundred thirty-six CT scans were performed and 19 shunt series were done. The median patient radiation was 6.9 mSv (range: 0 to 28.6 mSv); 85% of examinations were performed for neurosurgical control. The median absorbed radiation dose was higher in patients who were evaluated for some possible shunt malfunction than in patients without a suspected shunt malfunction (9 mSv vs 5 mSv, p=0.02).

The radiation exposure from radiological examinations performed on children with CFS was considerable. The use of non-ionizing techniques would help in the neurosurgical control of patients with CSF. The development of clinical-diagnostic scales could enable patients with increased risk of shunt malfunction to be selected before a radiological test was carried out.