Clinical investigation of exposure to ionizing radiation in 230 cases with Crohn's disease / 安徽医科大学学报

ABSTRACT

Objective To investigate the cumulative effective dose (CED) of ionizing radiation received by patients with Crohn's disease(CD) and to identify the risk factors associated with high levels of radiation in patients with Crohn's disease. Methods A total of 230 patients were enrolled. The classification of CD was according to the Montreal standards, and the CED of each patient was calculated retrospectively based on standards tables. High levels of radiation was defined as no less than 50 mSv CED. Patients who accepted no less than 50 mSv CED were assigned to high level of the radiation group, and those who accepted simultaneously less than 50 mSv CED were assigned to the control group. The risk factors for patients associating with high levels of radiation were analyzed by Logistic regression. Results CT enterography and abdominopelvic CT accounted for 52. 1％ and 39. 6％, respectively, and add up to 91. 7％ of total CED. The mean CED received per patient was 34. 07 mSv (95％ CI30. 845～37. 304), and 51 patients (22. 2％ of total patients) with CD were exposed to no less than 50 mSv CED. Patients with long disease duration, surgical intervention, ileal location, stricturing or penetrating pattern received a higher dose of radiation. In a Logistic regression, stricturing or penetrating pattern(OR =3. 711, 95％ CI2. 239 ～ 6. 151, P ＜0. 001) and the requirement for azathioprine (OR =4. 218, 95％ CI 1. 221 ～14. 579,P=0. 023) were independent risk factors for the high levels of radiation in CD. Conclusion More than one in five of patients with CD are exposed to high levels of ionizing radiation, mainly caused by CT examination. Stricturing or penetrating pattern and the usage of azathioprine are independent risk factors for the high levels exposure of radiation in CD patients. During the clinical management and follow-up, it is important to either monitor the effective dose received per patient, minimizing unnecessary CT examination, or to transform to use no radiation imaging examination, such as MR enterography.