RESUMO
Children are more sensitive to ionizing radiation than adults. Even though the risk is very low, exposure from radiological examinations can possibly cause them long-term side effects. Recent large epidemiological studies involving children and young adults have added evidence suggesting that even small doses of radiation, such as those from computed tomography scans, might slightly increase the risk of developing cancer later in life. Therefore, even though radiologic studies are essential for an accurate diagnosis and management of various conditions, it is crucial to minimize radiation exposure. This article addresses radiation protection for children in the medical use of ionizing radiation and it is set in the context of the European legislative framework regarding radiation protection. It advocates for a holistic approach to paediatric radiological tests. This approach includes the key principles of radiation protection, such as the justification of imaging procedures supported by referral guidelines, as well as the optimization of techniques (according to the ALARA principle) and effective communication with parents about the benefits and the risks of radiologic procedures. Protecting children from unnecessary radiation is not only a technical challenge, but also a moral obligation and a legal requirement.
RESUMO
BACKGROUND: Iterative reconstruction techniques (IRTs) are commonly used in computed tomography (CT) and help to reduce image noise. PURPOSE: To determine the minimum radiation dose while preserving image quality in head CT using IRTs. MATERIAL AND METHODS: The anthropomorphic phantom was used to scan nine head CT image series with varied radiation parameters. CT dose parameters, including volume CT dose index (CTDIvol [in mGy]) and dose length product (DLP [in mGy/cm]), were recorded for each scan series. Different noise levels (iDoseL1-6) were used in IRT reconstructions for soft and bone tissues. In total, 15 measurements were taken from five regions of interest (ROI) with an area of 10 mm2. The signal-to-noise ratio (SNR) and noise values obtained at different ROIs were compared among various reconstruction methods with repeated measures of statistical analysis. RESULTS: In the head CT scan, applying IRT iDoseL5 had the lowest noise and highest SNR for soft tissue (P < 0.05), and increased iDose can decrease CT dose by 54.6% without compromising image quality. While for bone tissue reconstruction, no clear association was found between the level of iDose and noise. However, when CTDIvol is >20 mGy, iDoseL4 is slightly superior to other reconstruction methods (P < 0.065). CONCLUSION: Using IRTs in head CTs reduces radiation dose while maintaining image quality. IDoseL5 provided optimal balance for soft tissue.
Assuntos
Interpretação de Imagem Radiográfica Assistida por Computador , Tomografia Computadorizada por Raios X , Humanos , Doses de Radiação , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Cabeça/diagnóstico por imagem , Razão Sinal-Ruído , AlgoritmosRESUMO
Patients with bile duct cysts require careful radiological assessment of the hepatobiliary system prior to surgical intervention. This clinical case is uncommon with an atypical clinical presentation and radiological findings. According to the most widely used classification of choledochal cysts, this case presents a combination of Type I and Type IV of choledochal cyst (CC) combining the form of extra, intrahepatic bile ducts and cystic duct dilations.
RESUMO
A 15-year-old female with primary amenorrhea, obesity, and insulin resistance, was admitted for further examination due to large pelvic masses found during a transabdominal ultrasound, which was performed while assessing the amenorrhea. The magnetic resonance imaging showed bilateral, multifocal fibrosing tumors, originating from both ovaries. A laparotomy was performed, during which the right ovary masses were enucleated and the left adnexectomy was performed. A histological examination of the tissue material revealed bilateral ovarian fibromas with calcification and ossification. The genetic examination confirmed the diagnosis of Gorlin syndrome. The patient recovered well, and on the first follow-up 1 month after surgery, already experienced her first spontaneous menstrual bleeding.