Loma Linda University Medical Center, Department of Internal Medicine, 11234 Anderson Street, Loma Linda, CA 92354-2804, USA.
Comput Med Imaging Graph. 2011 Jun;35(4):266-74. doi: 10.1016/j.compmedimag.2011.02.002. Epub 2011 Mar 3.
Clinical indications and utilization patterns for 3963 CT scans on 2500 consecutive patents on a 320-detector row CT in an outpatient setting were retrospectively analyzed and compared with previously reported CT studies. The impact of the latest generation CT technology, including whole organ perfusion, on indications and utilization patterns during the study period was also assessed. The top five requested CT scan types were abdomen/pelvis, chest, head, sinuses, and coronary CT angiography. Indication and utilization rates were similar to prior studies for abdomen/pelvis, non-cardiac chest, and head CT scans. Abdominal pain and headaches were the most frequent indications for abdomen/pelvis and head CTs, respectively. The 7.3% cardiac CT scan utilization rate was not comparable to rates of up to 72% in self-referral outpatient settings. Whole organ volume CT imaging was utilized in 100% of coronary CT angiography and 22.7% of head CTs. The 320-row CT had fewer negative head and body CT findings as compared to prior reports. The availability of new technology, such as whole organ dynamic scans, appears to have influenced CT indications, utilization and finding rates with a decrease in negative brain and body results. Comparisons with previous outpatient CT studies were similar for multiple categories with the exception of cardiac CT utilization, which is heavily influenced by self-referral. Further study of outpatient imaging indications and utilization rates from multiple centers may benefit from a standardized categorization to improve understanding of the disparate outpatient imaging environment.
回顾性分析了 2500 例连续门诊患者在 320 排 CT 上进行的 3963 次 CT 扫描的临床指征和利用模式,并与之前报道的 CT 研究进行了比较。还评估了包括全器官灌注在内的最新代 CT 技术对研究期间指征和利用模式的影响。请求的前五名 CT 扫描类型是腹部/骨盆、胸部、头部、鼻窦和冠状动脉 CT 血管造影。指征和利用率与之前的腹部/骨盆、非心脏胸部和头部 CT 扫描研究相似。腹部疼痛和头痛分别是腹部/骨盆和头部 CT 的最常见指征。7.3%的心脏 CT 扫描利用率与高达 72%的自我转诊门诊环境中的比率无法相比。全器官容积 CT 成像在 100%的冠状动脉 CT 血管造影和 22.7%的头部 CT 中得到应用。320 排 CT 的头部和身体 CT 阴性结果比之前的报告少。新的技术,如全器官动态扫描的可用性,似乎已经影响了 CT 指征、利用和发现率,导致阴性脑和身体结果减少。与之前的门诊 CT 研究相比,除了心脏 CT 利用率之外,多项类别都相似,后者受自我转诊的影响很大。来自多个中心的门诊影像指征和利用率的进一步研究可能受益于标准化分类,以提高对不同门诊影像环境的理解。