目的:计算机断层扫描肺血管造影(CTPA)对于评估妊娠期疑似肺栓塞具有重要意义,但具有母体/胎儿辐射风险。这项研究的目的是评估怀孕期间CTPA引起的母体和胎儿辐射诱发癌症的风险。
方法:通过美国国家癌症研究所的辐射风险评估工具进行的模拟建模用于估计怀孕期间CTPA的17个器官剂量的额外癌症风险,剂量由辐射剂量索引监测系统确定。器官剂量是从辐射剂量索引监测系统获得的。计算了男性和女性胎儿以及几个母亲年龄的每100,000名产妇和胎儿癌症风险。
结果:534个CTPA检查对乳房的母体器官剂量最高,肺,胃17.34、15.53和9.43mSv,分别,平均子宫剂量为0.21mSv。每100,000人患癌症的产妇总超额风险分别为181、151、121、107、94.5、84和74.4。对于20-,25-,30-,35-,40-,45-,50岁的女性正在接受CTPA,与基线癌症风险41,408的20岁患者相比.女性和男性胎儿每100,000人患癌症的总胎儿超额风险分别为12.3和7.3,分别,与基线癌症风险41,227和48,291相比。
结论:与妊娠患者和胎儿的基线癌症风险相比,CTPA发生癌症的额外风险较小,孕妇随着孕妇年龄的增加而减少,女性胎儿比男性胎儿更大。
OBJECTIVE: Computed tomography pulmonary angiogram (CTPA) is important to evaluate suspected pulmonary embolism in pregnancy but has maternal/fetal radiation risks. The objective of this
study was to estimate maternal and fetal radiation-induced cancer risk from CTPA during pregnancy.
METHODS: Simulation modeling via the National Cancer Institute\'s Radiation Risk Assessment Tool was used to estimate excess cancer risks from 17 organ doses from CTPA during pregnancy, with doses determined by a radiation dose indexing monitoring system. Organ doses were obtained from a radiation dose indexing monitoring system. Maternal and fetal cancer risks per 100,000 were calculated for male and female fetuses and several maternal ages.
RESULTS: The 534 CTPA examinations had top 3 maternal organ doses to the breast, lung, and stomach of 17.34, 15.53, and 9.43 mSv, respectively, with a mean uterine dose of 0.21 mSv. The total maternal excess risks of developing cancer per 100,000 were 181, 151, 121, 107, 94.5, 84, and 74.4, respectively, for a 20-, 25-, 30-, 35-, 40-, 45-, and 50-year-old woman undergoing CTPA, compared with baseline cancer risks of 41,408 for 20-year-old patients. The total fetal excess risks of developing cancer per 100,000 were 12.3 and 7.3 for female and male fetuses, respectively, when compared with baseline cancer risks of 41,227 and 48,291.
CONCLUSIONS: Excess risk of developing cancer from CTPA was small relative to baseline cancer risk for pregnant patients and fetuses, decreased for pregnant patients with increasing maternal age, and was greater for female fetuses than male fetuses.