McCollough Cynthia H, Guimarães Luís, Fletcher Joel G
Department of Radiology, Mayo Clinic, 200 First St. SW, East-2 Mayo Bldg., Rochester, MN 55905, USA.
AJR Am J Roentgenol. 2009 Jul;193(1):28-39. doi: 10.2214/AJR.09.2754.
Rapid technical developments and an expanding list of applications that have supplanted less accurate or more invasive diagnostic tests have led to a dramatic increase in the use of body CT in medical practice since its introduction in 1975. Our purpose here is to discuss medical justification of the small potential risk associated with the ionizing radiation used in CT and to provide perspectives on practice-specific decisions that can maximize overall patient benefit. In addition, we review available dose management and optimization techniques.
Dose reduction strategies described in this article must be well understood and properly used, but also require broad-based practice strategies that extend beyond the CT scanner console and default, generic manufacturer settings. In the final analysis, physicians must request the imaging examination that best addresses the specific medical question without allowing worries about radiation to dissuade them or their patients from obtaining needed CT examinations. Ongoing efforts to ensure that CT examinations are both medically justified and optimally performed must continue, and education must be provided to the medical community and general public that put both the potential risks--and benefits--of CT examinations into proper perspective.
自1975年CT问世以来,技术的快速发展以及一系列应用取代了准确性较低或侵入性更强的诊断测试,导致其在医学实践中的使用急剧增加。我们在此的目的是讨论与CT中使用的电离辐射相关的小潜在风险的医学合理性,并就能够使患者总体受益最大化的特定实践决策提供观点。此外,我们回顾现有的剂量管理和优化技术。
本文所述的剂量降低策略必须得到充分理解和正确使用,但也需要超越CT扫描仪控制台和默认的通用制造商设置的广泛实践策略。归根结底,医生必须要求进行最能解决特定医学问题的影像检查,而不让对辐射的担忧劝阻他们或他们的患者进行所需的CT检查。必须持续努力确保CT检查在医学上合理且执行最佳,并且必须向医学界和公众提供教育,使他们正确看待CT检查的潜在风险和益处。