CT scans and X-rays---Tests by the radiation dose.

来源: Lilac2003 2016-06-09 07:06:04 [] [博客] [旧帖] [给我悄悄话] 本文已被阅读: 次 (13078 bytes)

Where the rays are—and aren’t

The colored dots on each test below indicate its radiation dose.
 

Ultrasound

High-frequency sound waves sent through the body create echoes as they bounce off organs and tissues. Echoes are then turned into real-time images called sonograms. Produces fairly good images of soft-tissue disease, but they’re not very detailed, especially in obese patients. Radiation exposure: none.

MRI

Magnetic resonance imaging uses magnets and radio waves to create detailed images that can help spot cancers and soft-tissue problems. Patients are enclosed in the machine for 45 minutes to 2 hours before the image is captured. Radiation exposure: none.

Mammogram

Uses low-dose X-rays to spot masses and mineral deposits that could indicate breast cancer. Radiation exposure: low.

X-ray

The standard scan emits a broad beam that passes through the body before landing on film, casting shadowlike images. Fluoroscopy produces a continuous image, or X-ray movie. X-ray is excellent for bones. Radiation exposure: minimal to medium.

CT

Computed tomography uses a pencil-thin X-ray beam to create a series of images from multiple angles, which are then transferred to a computer, creating a 3D image that can be enlarged and rotated onscreen. Excellent for looking at soft tissue. Radiation exposure: minimal to high.

PET

Positron emission tomography requires the patient to ingest a radioactive tracer, usually thru injection, that lands in cells, especially cancer cells. Some machines that are used combine PET and CT scans. Radiation exposure: medium to high.

Tests by the radiation dose

Just one CT scan of the abdomen and pelvis equals about 10 millisieverts, more radiation than most residents of Fukushima, Japan, absorbed after the Fukushima Daiichi nuclear power plant accident in 2011.
 

Procedure

Radiation dose (millisievert) 1, 2

Comparable exposure from natural sources, such as radon

Should you get it?

Minimal dose: Less than 0.1 millivert

X-ray of teeth (bitewing)

 

0.005

less than 1 day

Most people need one only every 24 to 36 months.

X-ray of teeth (full mouth)

0.010

about 1 day

Many people can go a decade between exams.

Cone-beam CT of jaw and teeth

0.06

7 days

Rarely needed for most orthodontic procedures.

 

 

Low dose: 0.1 to 1 millivert

X-ray of chest (two views)

0.1

12 days

Presurgery X-rays needed only for people with a history of lung or heart disease

(or those at risk) or before chest surgery.

 

Mammogram

0.4

7 weeks

Needed every two years for women ages 50 to 74.

 

Medium dose: 1 to 10 milliverts

X-ray of spine

1.5

6 months

Rarely needed in first month back pain.

 

CT of head

2

8 months

Not needed for most head injuries. CTs usually aren’t needed for a concussion.

CT of spine

6

2 years

Rarely needed in first month of back pain.

 

High dose: 10 milliverts and over

CT colonoscopy

10

3 years

Not as accurate as standard colonoscopy.

 

CT of abdomen and pelvis

10

3 years

For possible appendicitis or kidney stone, ask whether ultrasound can be used.

 

CT angiography (of the heart)

12

4 years

1 in every 1,300 60-year-olds may get cancer as a result, so it probably shouldn’t be used for screening.

 

CT of abdomen and pelvis repeated with and without contrast

20

7 years

“Double scans” are rarely necessary; fewer than 5 percent of patients should receive one.

 

PET with CT

25

8 years

It exposes patients to very high radiation doses, so make sure that it is really necessary.

 

1. Doses are typical values for an average-sized adult. The actual dose can vary substantially depending on a person’s size as well as on differences in imaging. 2. For every 2,000 people exposed to 10 millisieverts of radiation from a ct scan, one will develop cancer, according to the Food and Drug Administration.

 

http://www.consumerreports.org/cro/magazine/2015/01/the-surprising-dangers-of-ct-sans-and-x-rays/index.htm
Editor's Note:

This article also appeared in the March 2015 issue of Consumer Reports magazine.   

所有跟帖: 

在冒风险检测時吃辐射,和检测早发现癌症之间取得平衡,这是挑战 -Lilac2003- 给 Lilac2003 发送悄悄话 Lilac2003 的博客首页 (321 bytes) () 06/09/2016 postreply 08:54:22

国内的体检中心做肺部CT好像是在每种体检套餐里都包含的。 -wudu- 给 wudu 发送悄悄话 (0 bytes) () 06/09/2016 postreply 13:09:17

吃辐射量据说是等同于乘坐飞机飞越北极10次的量(等于连续往返中美5次) -wudu- 给 wudu 发送悄悄话 (0 bytes) () 06/09/2016 postreply 13:12:15

上百个小时的能量在几分钟之内释放。 -石榴- 给 石榴 发送悄悄话 石榴 的博客首页 (0 bytes) () 06/09/2016 postreply 13:53:18

丁香MM,关于LDCT筛检肺癌,这里有篇文章可以看一下 -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (3016 bytes) () 06/09/2016 postreply 13:56:53

丁香有75%以上的可能LDCT检查正常,这就皆大欢喜了。如果不幸落到了约25%的不正常结果当中,就有点悲剧了。 -吃与活- 给 吃与活 发送悄悄话 吃与活 的博客首页 (298 bytes) () 06/09/2016 postreply 14:29:57

是,肺癌筛查没有好办法。高风险的可能值得折腾,一般人要我说就算了。 -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (0 bytes) () 06/09/2016 postreply 16:24:34

我觉得也是。 -吃与活- 给 吃与活 发送悄悄话 吃与活 的博客首页 (0 bytes) () 06/09/2016 postreply 16:55:20

+1 -虎嗅蔷薇- 给 虎嗅蔷薇 发送悄悄话 (0 bytes) () 06/09/2016 postreply 16:58:23

NLST这个研究的对象都是至少有30 pack-years吸烟史的老烟枪, -虎嗅蔷薇- 给 虎嗅蔷薇 发送悄悄话 (900 bytes) () 06/09/2016 postreply 16:33:06

那个指南还是很合理的,这就是所谓的循证医学。 -吃与活- 给 吃与活 发送悄悄话 吃与活 的博客首页 (0 bytes) () 06/09/2016 postreply 16:53:49

对! -虎嗅蔷薇- 给 虎嗅蔷薇 发送悄悄话 (0 bytes) () 06/09/2016 postreply 16:56:49

谢谢你的仔细解读。我又好好读了一下文章,你说的很准确。另外楼下说的是对的,要想早期抓住肺癌,需要年年筛查。 -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (178 bytes) () 06/09/2016 postreply 17:23:11

每年用CT查肺癌本身也会致癌, 这就是另一个重大原因为什么风险高的烟枪筛查才有意义 -志在千里- 给 志在千里 发送悄悄话 (5949 bytes) () 06/09/2016 postreply 19:42:52

同意!谢谢你提供的文献,Brenner是牛人呢,以前在会议上见过他一次,是keynote speaker -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (0 bytes) () 06/10/2016 postreply 04:40:04

也谢谢你提供的文献! 你还见过Brenner呢, 多好。我这里是不太知名的speaker以景仰的心情引用他的文章。。。 -志在千里- 给 志在千里 发送悄悄话 (90 bytes) () 06/10/2016 postreply 06:52:14

感谢 Vmm,吃与活教授,志醫,虎醫 etc 大家的理解和帮助,很感动.会读VMM推荐文章.权衡利弊, -Lilac2003- 给 Lilac2003 发送悄悄话 Lilac2003 的博客首页 (126 bytes) () 06/10/2016 postreply 06:59:17

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