Background/introduction
Chron’s disease (CD) is a primarily gastrointestinal inflammatory disease.
Any portion of the gastrointestinal tract may be involved, but the small bowel is affected alone in about a third of patients and the terminal ileum is affected in 90% of patients.
Pathologically, CD is characterized by transmural granulomatous inflammation.
The diagnosis of CD is based on a combination of clinical, laboratory, endoscopic, histological, and imaging findings, with no single diagnostic test allowing unequivocal diagnosis.
Imaging is used alongsideendoscopic techniquesand plays a role in the diagnosis,...
Description of activity and work performed
Material and Methods
We retrospectively included all CD patients from our hospital who underwent CT evaluations at our institution from 2010 to 2016, extracting the dose-length product (DLP) of each study.
Our evaluation included thorax and abdomen and/or pelvic CT exams, CT-enterographies, CT-colonographies and CT-guided interventions executed both as scheduled examinations and in the emergency setting. Studies exclusively of the thorax were excluded.
DLP was later converted to effective dose (ED) using a 0.015 conversion coefficient and the cumulative effective dose of radiation (CEDR) was...
Conclusion and recommendations
The presentation of some patients with CEDR levels > 100 mSv serves to raise awareness of the radiation dose seen in CT of CD patients as an attempt to exert a shift in the mentality of the medical professionals involved in the management of these patients.
Strategies to reduce radiation exposure over the patients’ lifetime, mainly through imaging assessment with MRI and multidisciplinary diagnostic decision consultations should be implemented.
Personal/organisational information
A. S. Linhares Moreira; Faro/PT - nothing to disclose M. Diniz; Faro/PT - nothing to disclose M. D. G. A. Afonso; Faro/PT - nothing to disclose
References
Magro F, Coelho R, Guimarães LS, Silva M, Peixoto A, Lopes S, Macedo G.Ionizing radiation exposure is still increasing in Crohn’s disease: Who should be blamed? Scandinavian Journal of Gastroenterology 2015; 50(10): 1214-25
Huda W, Ogden KM, Khorasani MR. Converting Dose-Length Product to Effective Dose at CT.
Radiology 2008; 248(3): 995-1003
Christner JA, Kofler JM, McCollough CH. Estimating Effective Dose for CT Using Dose–Length Product Compared With Using Organ Doses: Consequences of Adopting International Commission on Radiological Protection Publication 103 or Dual-Energy Scanning. AJR 2010;...