Heyer C M, Peters S, Lemburg S, Nicolas V
Institut für Diagnostische Radiologie, Interventionelle Radiologie und Nuklearmedizin, BG Kliniken Bergmannsheil, Ruhr-Universität Bochum.
Rofo. 2007 Mar;179(3):261-7. doi: 10.1055/s-2006-927366. Epub 2007 Jan 29.
Assessment of the knowledge of non-radiological physicians concerning radiation exposure during radiological procedures on the thorax.
124 non-radiological physicians from the departments of surgery, internal medicine, anesthesiology, and neurology at a university hospital were questioned during a four-week period using a standardized questionnaire as to the effective dose (ED) of different radiological procedures on the thorax. The interviewees were asked to estimate the ED of chest X-rays and CT examinations and to compare these with the ED of other radiological methods. Length of professional experience, field of clinical training, and hierarchical position were also documented. The T-test and chi-square test were used for statistical analysis.
119/124 (96.0 %) physicians with an average work experience of 8.2 years (0.3-32 years) were willing to participate. 47/119 (39.5 %) correctly estimated the ED of conventional chest X-ray (0.01-0.1 mSv), and 40/119 (33.6 %) correctly gauged the ED of adult chest CT (1-10 mSv). The ED of cardiac CT and pediatric chest CT without dose reduction (10-100 mSv) were correctly judged by 31/119 (26.1 %) and 32/119 (26.9 %), respectively. The correct ratio of the ED of chest X-ray to that of chest CT (factor 100-1000) was given by 28/119 (23.5 %), while 86/119 (72.3 %) underestimated the ratio. 50/119 (42.0 %) and 35/119 (29.4 %) correctly stated that the ED of pediatric chest CT without dose reduction and that of cardiac CT are greater than that of adult chest CT. 24/119 (20.2 %) and 10/119 (8.4 %) thought that the ED of low-dose chest CT is smaller than that of chest X-ray or chest MRI, respectively. The length of professional experience, field of clinical training, and hierarchical position of the participants did not have a significant influence on the test results.
Correct estimation of the ED of radiological chest examinations, especially that of CT examinations with a high ED, poses substantial difficulties for non-radiologists regardless of the length of professional experience and field of clinical training. In light of the increase in ordered radiological exams, targeted adaptation of medical school teaching content and promotion of pertinent continuing radiological education seem pressing.
评估非放射科医生对胸部放射检查过程中辐射暴露的了解情况。
在四周时间内，使用标准化问卷对某大学医院外科、内科、麻醉科和神经科的124名非放射科医生进行询问，了解不同胸部放射检查的有效剂量（ED）。受访者被要求估计胸部X光和CT检查的有效剂量，并将其与其他放射学方法的有效剂量进行比较。还记录了专业工作年限、临床培训领域和层级职位。采用T检验和卡方检验进行统计分析。
119/124（96.0%）名平均工作经验为8.2年（0.3 - 32年）的医生愿意参与。47/119（39.5%）正确估计了传统胸部X光的有效剂量（0.01 - 0.1毫希沃特），40/119（33.6%）正确估计了成人胸部CT的有效剂量（1 - 10毫希沃特）。心脏CT和未进行剂量降低的儿科胸部CT的有效剂量（10 - 100毫希沃特）分别被31/119（26.1%）和32/119（26.9%）正确判断。胸部X光与胸部CT有效剂量的正确比例（相差100 - 1000倍）由28/119（23.5%）给出，而86/119（72.3%）低估了该比例。50/119（42.0%）和35/119（29.4%）正确指出未进行剂量降低的儿科胸部CT和心脏CT的有效剂量大于成人胸部CT。24/119（20.2%）和10/119（8.4%）分别认为低剂量胸部CT的有效剂量小于胸部X光或胸部MRI。参与者的专业工作年限、临床培训领域和层级职位对测试结果没有显著影响。
无论专业工作年限和临床培训领域如何，非放射科医生正确估计胸部放射检查的有效剂量，尤其是高有效剂量的CT检查，都存在很大困难。鉴于放射检查订单的增加，针对性地调整医学院教学内容并推广相关的放射学继续医学教育显得十分迫切。
