Treier R, Aroua A, Verdun F R, Samara E, Stuessi A, Trueb Ph R
Radiation Protection Division, Federal Office of Public Health, 3003 Bern, Switzerland.
Radiat Prot Dosimetry. 2010 Dec;142(2-4):244-54. doi: 10.1093/rpd/ncq279. Epub 2010 Oct 6.
Diagnostic reference levels (DRLs) were established for 21 indication-based CT examinations for adults in Switzerland. One hundred and seventy-nine of 225 computed tomography (CT) scanners operated in hospitals and private radiology institutes were audited on-site and patient doses were collected. For each CT scanner, a correction factor was calculated expressing the deviation of the measured weighted computed tomography dose index (CTDI) to the nominal weighted CTDI as displayed on the workstation. Patient doses were corrected by this factor providing a realistic basis for establishing national DRLs. Results showed large variations in doses between different radiology departments in Switzerland, especially for examinations of the petrous bone, pelvis, lower limbs and heart. This indicates that the concept of DRLs has not yet been correctly applied for CT examinations in clinical routine. A close collaboration of all stakeholders is mandatory to assure an effective radiation protection of patients. On-site audits will be intensified to further establish the concept of DRLs in Switzerland.
瑞士为成人的21种基于适应症的CT检查制定了诊断参考水平（DRLs）。对在医院和私立放射学机构运行的225台计算机断层扫描（CT）扫描仪中的179台进行了现场审核，并收集了患者剂量。对于每台CT扫描仪，计算了一个校正因子，以表示测量的加权计算机断层扫描剂量指数（CTDI）与工作站上显示的标称加权CTDI的偏差。通过该因子对患者剂量进行校正，为建立国家DRLs提供了现实依据。结果显示，瑞士不同放射科之间的剂量存在很大差异，尤其是在岩骨、骨盆、下肢和心脏检查方面。这表明DRLs的概念在临床常规CT检查中尚未得到正确应用。所有利益相关者必须密切合作，以确保对患者进行有效的辐射防护。将加强现场审核，以进一步在瑞士确立DRLs的概念。
