经常性CT成像和患者辐射保护策略
Antonio Jreije1, Leonid Krynke1, Birutė Gricienė2
1Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
概括
一小部分患者从反复的CT扫描中积累了高剂量的辐射,通常只有很少的检查. 为了有效监测累积剂量,建立了36mSv的局部反复暴露参考水平 (RERL).
科学领域:
- 医疗成像医学成像
- 放射学 放射学是一门学科.
- 辐射安全 辐射安全
背景情况:
- 计算机断层扫描 (CT) 显著促进了医疗辐射暴露.
- 一部分患者累积高累积有效剂量 (CED),造成长期随机风险.
- 复发性暴露参考水平 (RERL) 是用于监测复发性成像患者累积剂量的建议基准.
研究的目的:
- 评估在三级医院的复发性CT成像中的累积辐射暴露.
- 确定超过高剂量值 (CED ≥100 mSv) 的患者比例.
- 建立一个本地RERL用于剂量监测.
主要方法:
- 在维尔纽斯大学医院Santaros Klinikos对成年人CT检查 (2022-2024) 的回顾性分析.
- 定义的复发患者是那些在2023年至少有一次CT,并在2022年,2023年或2024年进行额外CT的患者.
- 计算每年和三年CED发病率≥100mSv,并确定RERL作为复发患者每年CED的第75个百分位.
主要成果:
- 在三年内,78,258名患者接受了99,865次CT检查.
- 在9199名复发患者中,18.2%在三年内超过100mSv;68%在不到五次CT时做到这一点.
- 当地的RERL被确定为36 mSv.
结论:
- 一部分患者从复发性CT中积累了高辐射剂量,往往只有少数检查.
- 衍生的RERL与欧洲研究一致,支持其用于累积剂量监测.
- 系统的剂量跟踪和遵守理由/优化原则对于降低风险至关重要.
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