影响高剂量 (≥50mSv) 计算机断层扫描在急诊室的趋势和因素:四年分析
Hamid Shokoohi1, Melissa Meeker1, Kristofer Montoya1
1Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
高剂量计算机断层扫描 (CT) 扫描 (≥50 mSv) 在急诊室正在增加,尽管CT技术取得了进展. 大动脉和四肢CT显示最高剂量,需要审查协议以减轻辐射风险.
科学领域:
- 放射学 放射学是一门学科.
- 医疗成像医学成像
- 辐射瘤学 辐射瘤学
背景情况:
- 计算机断层扫描 (CT) 技术已经进步,减少了许多程序的辐射暴露.
- 然而,某些CT检查仍然涉及高辐射剂量 (≥50mSv),造成辐射诱导癌症的风险.
研究的目的:
- 在四年内调查急诊室 (ED) 高剂量CT扫描 (≥50mSv) 的发生率和趋势.
- 确定导致使用高剂量CT扫描的因素.
主要方法:
- 一项回顾性队列研究分析了2019年至2022年期间从第三级护理医院的ED中获得的CT扫描.
- 包括成人患者 (≥18岁) 进行一次CT扫描,剂量≥50mSv.
- 数据分析了基于年龄,性别,扫描类型,扫描器模型,对比度使用和检查年份的辐射剂量变化.
主要成果:
- 在166,000多个CT扫描中,1357个 (0.81%) 是高剂量 (≥50mSv).
- 大动脉CT (62%) 是最常见的,其次是胸部/腹部/骨盆扫描 (14%). 在四肢CT (中位数67mSv),大动脉扫描 (中位数60mSv) 和胸部/腹部/骨盆研究 (中位数59mSv) 中观察到最高剂量.
- 高剂量CT的百分比从2019年的0.50%增加到2022年的0.92%,中位数剂量从57mSv增加到60mSv. 在89%的高剂量扫描中使用了IV对比剂.
结论:
- 在ED中高剂量CT检查虽然不常见,但尽管技术进步,但已经增加了.
- 特殊的协议,如大动脉成像和多相四肢研究,经常与这些高剂量有关.
- 这些发现强调需要审查CT协议并提高对辐射风险的认识.
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