Computed tomography (CT) has vital role in diagnosis of various pathologies using cross sectional images. Besides the advantages of CT in pediatric radiology, radiation dose has a significant adverse effect as children are more vulnerable than adults. Establishing Diagnostic Reference levels (DRLs) will determine unusual increase in radiation doses and therefore helps in optimizing the radiation dose by maintaining optimum diagnostic image quality. The objective of the review is to explore the literature on DRLs in pediatric CT examinations and techniques that have been used to establish them. Detailed search was done in PubMed-Medline, Scopus CINAHL, Web of Science, and the Cochrane Library databases to find studies that have established DRLs for pediatric CT examinations. The Preferred Reporting Items for Systematic Review and Meta-Analyses methodology was used to assess the relevant articles. The articles which assessed DRLs in pediatric CT examinations were included. A total of 501 articles were identified, of which 21 articles were included after a detailed screening process. Our review showed increased in pediatric patient dose surveys across the world and also increased in awareness for establishing DRLS among pediatric CT examinations. The review also demonstrated wide variation in DRLs and also deviation in the scanning techniques, protocols used and categorization methods used for establishing DRLs. As the pediatric population is more sensitive to radiation, the current review emphasizes the need for optimization of protocols and international standardization for establishing DRLs to facilitate a more feasible way of comparison of dose globally across CT sites.


中文翻译：

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儿科人群计算机断层扫描检查的诊断参考水平 - 系统评价


计算机断层扫描 (CT) 在使用横截面图像诊断各种病理方面具有至关重要的作用。除了 CT 在儿科放射学中的优势外，由于儿童比成人更容易受到影响，因此辐射剂量具有显着的不利影响。建立诊断参考水平 (DRL) 将确定辐射剂量的异常增加，因此有助于通过保持最佳诊断图像质量来优化辐射剂量。本综述的目的是探索儿科 CT 检查中 DRL 的文献以及用于建立 DRL 的技术。在 PubMed-Medline、Scopus CINAHL、Web of Science 和 Cochrane 图书馆数据库中进行了详细搜索，以查找已建立儿科 CT 检查 DRL 的研究。系统评价和元分析方法的首选报告项目用于评估相关文章。包括在儿科 CT 检查中评估 DRL 的文章。共识别出 501 篇文章，其中 21 篇文章经过详细筛选后被纳入。我们的审查显示，全世界的儿科患者剂量调查有所增加，并且在儿科 CT 检查中建立 DRLS 的意识也有所提高。审查还显示了 DRL 的广泛差异，以及用于建立 DRL 的扫描技术、使用的协议和分类方法的偏差。由于儿科人群对辐射更敏感，