CT做多了会患癌，是真的吗？
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">近期</span>，一则“CT每多做一次，患癌<span style="color: black;">危害</span>就<span style="color: black;">增多</span>43%”的科普视频冲上热搜，让不少网友产生担忧。放射科<span style="color: black;">检测</span>都有辐射吗？辐射会<span style="color: black;">引起</span>患癌吗？让<span style="color: black;">咱们</span>来逐一梳理。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">放射科<span style="color: black;">检测</span>都有辐射吗</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">辐射这个词<span style="color: black;">大众</span>都不陌生，<span style="color: black;">然则</span>它看不见、摸不着，<span style="color: black;">因此呢</span>很难直观感受其<span style="color: black;">是不是</span>存在。事实上，并非所有放射科<span style="color: black;">检测</span>都有辐射。放射科<span style="color: black;">检测</span><span style="color: black;">重点</span>有“三员大将”：DR（数字化拍片）、CT（电子计算机体层扫描）、MRI（磁共振<span style="color: black;">影像</span>）。其中<strong style="color: blue;">DR和CT确实有辐射，但MRI是<span style="color: black;">无</span>辐射的</strong>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">年度体检项目中最<span style="color: black;">平常</span>的胸部CT属于低剂量CT，其辐射量相对较小，并不会给身体<span style="color: black;">导致</span><span style="color: black;">很强</span><span style="color: black;">包袱</span>，但能<span style="color: black;">发掘</span>大部分<span style="color: black;">必须</span>关注的病灶。即使是胸部平扫/高分辨/<span style="color: black;">加强</span>CT，辐射量<span style="color: black;">亦</span>不足以<span style="color: black;">导致</span>严重的身体损害。<strong style="color: blue;">在规范的就诊过程中，CT<span style="color: black;">检测</span>对身体的影响<span style="color: black;">能够</span>忽略不计。</strong>遵医嘱在必要的<span style="color: black;">状况</span>下进行<span style="color: black;">检测</span>，不<span style="color: black;">必须</span>担心辐射的影响。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">网传视频中展示的内容源于2023年11月<span style="color: black;">发布</span>在《自然·医学》（Nature Medicine）杂志上的一项<span style="color: black;">科研</span>。这项<span style="color: black;">科研</span>的<span style="color: black;">科研</span>对象是22岁以下接受过CT<span style="color: black;">检测</span>的青少年，<span style="color: black;">况且</span>关注的重点是血液系统恶性肿瘤。在<span style="color: black;">仔细</span><span style="color: black;">报告</span>中<span style="color: black;">亦</span><span style="color: black;">知道</span>强调：只要接受的总辐射量在安全范围内，<span style="color: black;">就可</span>视为“基本不会对人体<span style="color: black;">导致</span>额外<span style="color: black;">损伤</span>，<span style="color: black;">病人</span><span style="color: black;">亦</span>不必过度忧虑”。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">因此呢</span>，“CT每多做一次，患癌<span style="color: black;">危害</span>就<span style="color: black;">增多</span>43%”，<strong style="color: blue;">这种说法不准确</strong>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">辐射对身体的<span style="color: black;">损伤</span>有多大</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">当人体受辐射剂量达到<span style="color: black;">必定</span>量后，会<span style="color: black;">诱发</span>某些健康问题，如脱发、白血病和<span style="color: black;">不育</span>症等。引发白内障的辐射阈剂量为5000毫格瑞，<span style="color: black;">倘若</span><span style="color: black;">小于</span>这个剂量，不会<span style="color: black;">由于</span>辐射而患白内障。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">随机影响<span style="color: black;">指的是</span>辐射<span style="color: black;">损害</span>（<span style="color: black;">疾患</span>）<span style="color: black;">出现</span>的概率与剂量<span style="color: black;">体积</span><span style="color: black;">相关</span>，但严重程度与剂量<span style="color: black;">体积</span><span style="color: black;">没</span>关，并且不存在阈剂量。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">根据</span><span style="color: black;">关联</span>标准，普通公众一年接受辐射剂量的本底是2毫西弗，年平均辐射剂量是20毫西弗，上限是50毫西弗。一次普通X线<span style="color: black;">检测</span>的辐射剂量是0.02毫西弗，一次CT<span style="color: black;">检测</span>的辐射剂量为2~10毫西弗。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">只要不是频繁做<span style="color: black;">检测</span>，就不必担心辐射的问题。</span></strong><span style="color: black;">当临床治疗<span style="color: black;">必须</span>做这些<span style="color: black;">检测</span>时，不要<span style="color: black;">由于</span>担心辐射而拖着不做，<span style="color: black;">以避免</span>延误诊治。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">事实上，<span style="color: black;">咱们</span>的生活环境中<span style="color: black;">亦</span>存在辐射。例如，坐飞机20小时的辐射剂量为0.1毫西弗；<span style="color: black;">每日</span>吸20支烟，每年的累积辐射剂量为0.5~2毫西弗……</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">检测</span>时<span style="color: black;">怎样</span>降低辐射</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">做CT<span style="color: black;">检测</span>时<span style="color: black;">重视</span>以下几点可缩短<span style="color: black;">检测</span>时间，减少身体的受辐射剂量。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">第1</span>，摘除金属物品。</span></strong><span style="color: black;">在进入CT室之前，<span style="color: black;">大夫</span>会提示将金属物品摘除。有时女性还<span style="color: black;">必须</span>把内衣脱掉，<span style="color: black;">以避免</span>金属物品影响<span style="color: black;">检测</span>结果的准确性。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">第二，<span style="color: black;">协同</span><span style="color: black;">大夫</span>完成<span style="color: black;">检测</span>。</span></strong><span style="color: black;">做CT<span style="color: black;">检测</span>时，<span style="color: black;">大夫</span>会提出<span style="color: black;">有些</span><span style="color: black;">需求</span>，<span style="color: black;">必须</span><span style="color: black;">病人</span><span style="color: black;">协同</span>，如按指令吸气、憋气等。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">第三，按秩序<span style="color: black;">检测</span>。</span></strong><span style="color: black;">在放射科等候<span style="color: black;">检测</span>时，<span style="color: black;">必须</span>在走廊候诊，不可进入<span style="color: black;">检测</span>室等候。<span style="color: black;">检测</span>时，受检者以外人员均要离开<span style="color: black;">检测</span>室。<span style="color: black;">倘若</span><span style="color: black;">必须</span>他人陪检，陪检人员应采取防护<span style="color: black;">办法</span>。孕妇及备孕人员在进行放射<span style="color: black;">检测</span>前，应提前将<span style="color: black;">自己</span><span style="color: black;">状况</span><span style="color: black;">通知</span>摄片<span style="color: black;">大夫</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">文：</span><span style="color: black;">湖南省胸科医院放射科<span style="color: black;">专家</span> 凌杰</span></p>
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