Harieaswar Sreemathi, Rajesh Arumugam, Griffin Yvette, Tyagi Raman, Morgan Bruno
Department of Radiology, Leicester Royal Infirmary, Leicester LE1 5WW, England.
Radiology. 2009 Jan;250(1):246-53. doi: 10.1148/radiol.2493080353.
The purpose of this retrospective medical audit was to evaluate the effect of discontinuing routine administration of oral contrast material to oncology patients undergoing follow-up multidetector computed tomography (CT) on reader evaluation of study adequacy. Analysis of 100 patients' experience of CT shows that positive oral contrast material was their least pleasant experience (P < .0001). Abandoning the routine use of positive oral contrast material for follow-up scans in general oncology patients undergoing multidetector CT, with section reconstruction thickness of 2.5 mm, was audited for 447 patents and included 5-13-month follow-up. The patient satisfaction study and clinical audit were performed according to local institutional audit guidelines. Since this was a clinical audit project, ethical approval was not required under UK National Health Service research governance arrangements. No patient needed to be recalled, no related diagnostic error has been reported, and follow-up CT, available in 285 of 447 cases (64%), revealed no error on the audited scan. We conclude that the routine use of positive oral contrast material is unnecessary for follow-up multidetector CT for general oncology indications.
这项回顾性医学审计的目的是评估停止对接受随访多排螺旋计算机断层扫描(CT)的肿瘤患者常规给予口服对比剂对阅片者评估检查充分性的影响。对100例患者CT检查体验的分析表明,口服阳性对比剂是他们最不愉快的体验(P <.0001)。对447例接受多排螺旋CT检查、层厚重建为2.5 mm的普通肿瘤患者在随访扫描时放弃常规使用阳性口服对比剂的情况进行了审计,随访时间为5至13个月。患者满意度研究和临床审计按照当地机构的审计指南进行。由于这是一个临床审计项目,根据英国国家医疗服务体系研究管理安排,无需伦理批准。没有患者需要被召回,没有报告相关诊断错误,447例中的285例(64%)有随访CT,显示审计扫描无错误。我们得出结论,对于普通肿瘤适应证的随访多排螺旋CT,常规使用阳性口服对比剂是不必要的。