Better ultrasound and MRI instead of X-ray and CT

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Pediatric radiologists are increasingly using ultrasound and MRI in young patients

Children are far more sensitive to radiation exposure than adults because their bodies are still growing. For this reason, doctors try to avoid X-rays and CT examinations in young patients as much as possible and instead use ultrasound and magnetic resonance imaging (MRI) to examine them.

Children are more sensitive to radiation exposure than adults. Radiation exposure through imaging methods such as X-ray and computed tomography (CT) can be more stressful for children than for adults. The reason: since the child's body is still growing, the cells divide faster. As a result, the radiation during cell division can lead to the formation of pathological cells, which in turn may trigger cancer. In this case, a healthy body can usually successfully defend itself. But "children are more sensitive to the individual radiation exposure, which adds up and increases the risk with each further X-ray exposure", explains Prof. Dr. Hans-Joachim Mentzel from the University Hospital Jena.

Ultrasound is a safe alternative even in the case of broken bones. To avoid risks, doctors therefore try to avoid X-rays and CT as much as possible for the little patients, because the radiation can even damage the genetic material. Instead, MRI or ultrasound are being used more and more, which is often used successfully even with broken bones. Several studies have already shown that ultrasound is particularly "equivalent to X-rays in long bones and that ultrasound can be used as an alternative to X-rays in children," according to the current press release from the Society for Pediatric Radiology. Accordingly, "through the sensible use of ultrasound, in addition to a significant acceleration of the diagnostic examination, a significant reduction in the medically caused radiation exposure in children" can be achieved, says Dr. Bernd Schweiger from Essen University Hospital.

Experts advise on alternatives in the pediatric radiologist Children in Radiology - an important topic with which more than 250 experts from the fields of radiology, pediatrics, neuroradiology, nuclear medicine and cardiology will be working on from the weekend to the 50th annual conference of the Society for Pediatric Radiology employed in Jena. "Radiation protection plays a particularly important role in pediatric radiology," emphasizes conference leader Prof. Hans-Joachim Mentzel. This is shown, for example, by an Australian study with 680,000 subjects. According to this, children and adolescents who had been examined by CT had a 24 percent higher risk of leukemia or so-called "solid" tumors compared to other patients, Mentzel told the "Welt".

More and more CT examinations in the USA Despite this danger, according to Professor Mentzel, more and more CT examinations are being carried out, particularly in the USA, both for adults and for children. In Germany, on the other hand, the numbers are “relatively stable with the exception of emergency CT examinations in the event of an accident.” In normal clinical practice, however, ultrasound and MRI are being used more and more in pediatric radiology. The children could be examined "completely" from curl to sock "by ultrasound", explains Mentzel. Only very few places - such as the lungs - could not be reached with this procedure.

X-ray passport for children to avoid unnecessary examinations In general, Mentzel believes that attempts should be made to keep ionizing radiation completely away from children, because there has so far been no reliable result as to how much radiation a young person can tolerate. In order to avoid errors in x-rays, doctors should also generally follow the "guidelines of the children's radiology society". However, according to Mentzels, the physician must of course decide which procedure is necessary for the diagnosis in individual cases. In order not to double-examine children out of ignorance, an X-ray passport provides useful assistance that every child should have with them. All examinations are entered in this, so that every treating physician can immediately get an overview. (No)

Image: Christoph Droste /

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