METHODS: A scoping literature review over a 23 year period between 2000 and 2023 was conducted of all English-language studies reporting on the use of non-contrast CT imaging for assessment of pediatric urolithiasis. Patients that were specified as pediatric with age ≤20 years at time of intervention and undergoing standard-dose or low/ultra-low-dose CT were included. Low-dose and ultra-low-dose CT were defined as a radiation dose ≤3.0 mSv and ≤1.9 mSv, respectively.
RESULTS: A total of 8121 articles were identified and after screening, 6 articles representing 309 patients were included in this scoping review. Of the articles reviewed, standard non-contrast CT radiation doses for pediatric urolithiasis evaluation ranged from 2.9 to 5.5 mSv and low-dose CT radiation dose was reported to be 1.0-2.72 mSv. Only 2 studies directly evaluated low-dose CT imaging compared to standard-dose CT imaging for pediatric urolithiasis assessment. Radiation reduction approaches did not negatively impact urolithiasis detection or characterization in 2 studies reviewed.
CONCLUSIONS: CT radiation doses for suspected or known pediatric urolithiasis are underreported and vary greatly with underutilization of low-dose/ultra-dose protocols for pediatric urolithiasis especially in comparison to the adult population. Results from this scoping review support that low-dose CTprotocols for pediatric stone disease are feasible to reduce radiation exposure.
方法:对2000年至2023年的23年期间的所有英语研究进行了范围界定文献综述,报告使用非造影CT成像评估小儿尿石症。包括在干预时年龄≤20岁并接受标准剂量或低/超低剂量CT的儿童患者。低剂量和超低剂量CT定义为辐射剂量≤3.0mSv和≤1.9mSv,分别。
结果:共鉴定出8121篇文章,经过筛选,本范围审查包括6篇代表309名患者的文章。在审查的文章中,儿童尿石症评估的标准非对比CT辐射剂量为2.9~5.5mSv,低剂量CT辐射剂量为1.0~2.72mSv.与标准剂量CT成像相比,只有2项研究直接评估了低剂量CT成像对小儿尿石症的评估。在所审查的2项研究中,减少辐射的方法并未对尿石症的检测或表征产生负面影响。
结论:疑似或已知小儿尿石症的CT辐射剂量被低估,并且随着低剂量/超剂量方案对小儿尿石症的利用不足,差异很大,尤其是与成年人相比。这项范围审查的结果支持,针对小儿结石疾病的低剂量CT方案对于减少辐射暴露是可行的。