在轴性脊椎关节炎中CT前的冗余放射:高辐射负担,诊断价值有限
Elif Kurtulus1, Tuba Yuce Inel1, Ozkan Urak1
1School of Medicine, Department of Rheumatology, Dokuz Eylul University, Izmir, Turkiye.
Rheumatology (Oxford, England)
|February 3, 2026
概括
用于诊断轴性脊椎关节炎 (r-axSpA) 的多次盆腔和腰部放射图通常会导致大量的辐射暴露. 一次低剂量计算机断层扫描 (CT) 扫描可以在更少的冗余辐射暴露下提供结构评估.
科学领域:
- 放射学 放射学是一门学科.
- 类风湿病学 类风湿病学
- 医疗成像医学成像
背景情况:
- 放射性轴性脊椎关节炎 (r-axSpA) 的诊断通常涉及初始的骨盆和腰部放射.
- 通过CT进行最终诊断之前,这些重复放射的累积辐射剂量并未得到很好的量化.
- 评估传统诊断途径的辐射暴露对于优化患者护理至关重要.
研究的目的:
- 在CT诊断r-axSpA之前,量化盆腔和腰部X光片的数量和累积辐射剂量.
- 评估通过使用CT而不是重复射线图来减少辐射剂量的潜力.
- 为了比较放射系列中的辐射剂量与拟议的CT基准值.
主要方法:
- 从机构和国家数据库中对从CT确认r-axSpA之前获得的盆腔和腰部X射线图的回顾性审查.
- 应用文献推导的有效剂量估计来计算最小和最大限度的累积放射剂量.
- 累积X射线剂量与假设的低剂量 (0.5mSv) 和常规 (4-10mSv) CT场景的比较,使用威尔科克森签名等级测试.
主要成果:
- 在CT前,共进行了235次X射线图,平均每患者2.47,大多数患者 (77.9%) 进行了多次成像.
- 最低限度累积X射线剂量在0.00-1.60mSv (中位数0.40mSv) 之间,最大剂量在0.20-11.20mSv (中位数2.80mSv) 之间.
- 在最小剂量假设下,放射性暴露与低剂量CT相似;然而,在最大假设下,暴露显著更高 (p<0.001).
结论:
- 在r-axSpA中确定的CT诊断之前,经常进行多次盆腔和腰部放射,这有助于显著的辐射暴露.
- 一次,适当指定的低剂量CT扫描可以实现结构评估,与连续放射相比,潜在的多余辐射暴露可能更少.
- 优化诊断成像途径可能会降低疑似r-axSpA.患者的累积辐射剂量.
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