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Indicators02:39

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Certain organic substances change color in dilute solution when the hydronium ion concentration reaches a particular value. For example, phenolphthalein is a colorless substance in any aqueous solution with a hydronium ion concentration greater than 5.0 × 10−9 M (pH < 8.3). In more basic solutions where the hydronium ion concentration is less than 5.0 × 10−9 M (pH > 8.3), it is red or pink. Substances such as phenolphthalein, which can be used to determine the pH of a solution, are...
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Pericarditis II: Clinical Features and Diagnostic Tests01:19

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Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
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Atherosclerosis II: Clinical Manifestations and Diagnostic Tests01:27

Atherosclerosis II: Clinical Manifestations and Diagnostic Tests

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Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

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Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
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Mitral Regurgitation II: Clinical Features and Diagnostic Tests01:23

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Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
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CTにおける臨床指標に基づく診断基準レベル：システマティックレビュー

Abdul Alim1,2, Sook Sam Leong3,4, Ann Erynna Lema Thomas Sudin1

  • 1Center for Medical Imaging Studies, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia.

BMJ open
|February 4, 2026
PubMed
まとめ

臨床指標（NDRLci）に基づく全国診断基準レベルはCTで大きく異なる。NDRLci開発の標準化は、CT線量の世界的な比較可能性を向上させるために不可欠である。

キーワード:
コンピューテッドトモグラフィー診断画像放射線科・画像診断

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科学分野:

  • 放射線物理学および医用画像
  • 診断画像および放射線防護

背景:

  • 臨床指標（NDRLci）に基づく全国診断基準レベルは、ICRP 2017の推奨に続いて世界的に採用が拡大している。
  • NDRLciの実践には大きなばらつきがあり、比較分析と影響要因の特定が必要とされている。

研究 の 目的:

  • CT検査における国際的なNDRLciの実践を比較すること。
  • 様々な臨床指標にわたるNDRLci値に影響を与える要因を特定すること。
  • 標準化されたNDRLciを開発するためのエビデンスに基づいた推奨事項を提案すること。

主な方法:

  • 1996年から2025年の間に発表された研究の体系的な文献レビュー。
  • PubMed、Web of Science、Scopusで検索を実施。
  • PRISMAガイドラインを遵守し、Joanna Briggs Instituteツールを使用してクリティカルアプレイザルを実施。

主要な成果:

  • 11件の研究が含まれ、7つの解剖学的領域にわたる25の臨床指標が分析された。
  • 重症外傷における全身CTで報告されたNDRLci（DLP）が最も高く（3830 mGy cm）、副鼻腔炎では最も低かった（70 mGy cm）。
  • 同じ臨床指標で線量の大きな乖離が観察された。

結論:

  • CT技術、プロトコルパラメータ、患者の特性などの要因がNDRLciに影響を与える。
  • 標準化され最適化されたCTプロトコルが不可欠である。
  • NDRLci開発の国際標準化は、世界的な比較可能性のために極めて重要である。