<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022025000300124</article-id>
<article-id pub-id-type="doi">10.51481/amc.v67i3.1469</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Experiencia con estudios radiológicos contrastados especiales pediátricos y comparación de indicadores operativos]]></article-title>
<article-title xml:lang="en"><![CDATA[Experience with special pediatric contrast radiological studies and comparison of operational indicators]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Navarro-Carrillo]]></surname>
<given-names><![CDATA[Marián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sandoval-Barboza]]></surname>
<given-names><![CDATA[María Nazareth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chaves-Campos]]></surname>
<given-names><![CDATA[Fabio Andrés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Noguera-Contreras]]></surname>
<given-names><![CDATA[María Fernanda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Camacho-González]]></surname>
<given-names><![CDATA[Adriana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Costa Rica Escuela de Tecnologías en Salud ]]></institution>
<addr-line><![CDATA[ San José]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Costa Rica Escuela de Tecnologías en Salud ]]></institution>
<addr-line><![CDATA[ San José]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Costa Rica Instituto de Investigaciones en Salud Sección de Genética]]></institution>
<addr-line><![CDATA[ San José]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad de Costa Rica Instituto de Investigaciones en Salud Sección de Genética]]></institution>
<addr-line><![CDATA[ San José]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad de Costa Rica Escuela de Tecnologías en Salud ]]></institution>
<addr-line><![CDATA[ San José]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2025</year>
</pub-date>
<volume>67</volume>
<numero>3</numero>
<fpage>124</fpage>
<lpage>133</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022025000300124&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022025000300124&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022025000300124&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo:  con el incremento del uso de las técnicas por imagen en la atención de la población pediátrica, considerada más radiosensible que la población adulta, se hace necesaria la optimización de los estudios radiológicos contrastados. El objetivo fue describir la experiencia con los estudios radiológicos contrastados especiales realizados en el Servicio de Radiología del Hospital Nacional de Niños y mostrar una comparación de la práctica clínica con referentes internacionales.  Métodos:  estudio observacional, transversal, con registro de los estudios efectuados, con sus parámetros técnicos y procedimentales, realizados desde el 15 de marzo hasta el 15 de junio del 2023. Se recolectó la información sobre los tipos de procedimientos, el número de imágenes generadas por estudio, la edad de los pacientes y el tiempo de fluoroscopia. Los datos tabulados se clasificaron según el tipo de estudio y el rango etario, se compararon con los valores reportados por referentes internacionales obtenidos mediante una revisión bibliográfica dirigida. Se realizó otra revisión bibliográfica acerca de los referentes teóricos internacionales y nacionales sobre la protección radiológica para la elaboración de una propuesta de optimización técnica.  Resultados:  se incluyó un total de 511 estudios radiológicos contrastados especiales pediátricos: 167 cistouretrografías miccionales seriadas, 126 estudios de tracto gastrointestinal, 124 esofagogramas y 94 de colon por enema. Con la cistouretrografía miccional seriada se registró un promedio de 35,8 imágenes y un tiempo de fluoroscopia promedio de 17 segundos, con una exposición que varió entre los 2 y 195 segundos con una mediana de 12 segundos. Para los otros estudios contrastados con bario, de forma agrupada el promedio fue de 93,6 imágenes adquiridas, con un tiempo de fluoroscopia promedio de 31,2 segundos siendo variable entre 1 y 229 segundos; específicamente con una mediana de 22 segundos para el colon por enema y 20.5 segundos para el esofagograma. La comparación con todos los referentes fue consistente en mostrar un menor tiempo de fluoroscopia y un mayor número de imágenes generadas por estudio en Costa Rica. Se compiló una serie de 14 acciones para orientar las estrategias de protección.  Conclusiones:  los tiempos de fluoroscopia utilizados en el país son menores a los típicamente empleados en otros contextos para los estudios seleccionados; sin embargo, el número de radiografías intraprocedimiento realizadas localmente fue mayor. Como parte de la estrategia para mejorar la protección radiológica, se sugiere incrementar ligeramente los tiempos de fluoroscopia con el propósito de reducir la cantidad de radiografías, lo que optimizaría el balance entre la calidad diagnóstica y la exposición a la radiación.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective:  With the increased use of imaging techniques in pediatric care, a population considered more radiosensitive than adults, the optimization of contrast-enhanced radiological studies is essential. The objective was to describe the experience with specialized pediatric contrast-enhanced radiological studies performed at the Radiology Department of the Dr. Carlos Sáenz Herrera National Children&#8217;s Hospital and to compare clinical practice with international benchmarks.  Methods:  This was an observational, cross-sectional study, recording all procedures performed, including their technical and procedural parameters, from March 15 to June 15, 2023. Information was collected on the types of procedures, the number of images generated per study, patient age, and fluoroscopy time. Fluoroscopy time and number of images generated per study were defined based on the distribution of the median values for fluoroscopy time and number of images. The tabulated data, classified by study type and age range, were compared with values reported by international references, obtained through a targeted literature review. A separate literature review of international and national theoretical frameworks on radiation protection was also conducted to develop a proposal for technical optimization.  Results:  A total of 511 pediatric special contrast radiological studies were included: 167 voiding cystourethrograms, 126 gastrointestinal tract studies, 124 esophagograms and 94 contrast enemas. With serial voiding cystourethrography, an average of 35.8 images were recorded, with an average fluoroscopy time of 17 seconds and an exposure time ranging from 2 to 195 seconds, with a median of 12 seconds. For the other barium contrast studies, the average number of images acquired was 93.6, with an average fluoroscopy time of 31.2 seconds, ranging from 1 to 229 seconds; specifically, the median was 22 seconds for the barium enema and 20.5 seconds for the esophagogram. Comparisons with all reference studies consistently showed shorter fluoroscopy times and a higher number of images generated per study in Costa Rica. A series of 14 actions was compiled to guide protection strategies.  Conclusions:  Fluoroscopy times used in the country are shorter than those typically employed in other contexts for the selected studies; however, the number of intraprocedural radiographs taken local was higher. As part of the strategy to improve radiation protection, it is suggested that fluoroscopy times be slightly increased to reduce the number of radiographs, thereby optimizing the balance between diagnostic quality and radiation exposure.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[fluoroscopia]]></kwd>
<kwd lng="es"><![CDATA[radiología]]></kwd>
<kwd lng="es"><![CDATA[pediatría]]></kwd>
<kwd lng="es"><![CDATA[protección radiológica]]></kwd>
<kwd lng="es"><![CDATA[optimización de procesos]]></kwd>
<kwd lng="en"><![CDATA[fluoroscopy]]></kwd>
<kwd lng="en"><![CDATA[radiology]]></kwd>
<kwd lng="en"><![CDATA[pediatrics]]></kwd>
<kwd lng="en"><![CDATA[radiation protection]]></kwd>
<kwd lng="en"><![CDATA[process optimization.]]></kwd>
</kwd-group>
</article-meta>
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