Department of Radiology, University of Washington, Seattle, Washington 98195-7987, USA.
J Am Coll Radiol. 2011 Apr;8(4):242-50. doi: 10.1016/j.jacr.2010.11.005.
To examine variation in pediatric trauma head CT imaging protocols in Washington state.
A web-based survey was sent to trauma-designated hospitals in Washington state. Respondents were queried about pediatric head trauma volumes, type of CT scanners, and technical information about the CT imaging protocols. Variation in pediatric trauma volumes, CT dose reduction strategies, and effective dose by trauma center levels was examined. Mean head effective dose and organ dose for a female baby were estimated.
We achieved a 76% overall response rate. Of the 2,215 children who received head CT scans, 36.3% (n=805) received head CT imaging at level 4 trauma center facilities, followed by level 1 trauma center (31.4%; n=695), level 3 trauma center (19.7%; n=436), level 2 trauma center (12%; n=267), and Level 5 (0.5%; n=12) facilities. Most responding trauma center facilities (44/47) reported having a pediatric specific imaging head CT protocols. However, compared to levels 1 and 2 trauma centers together, a greater proportion of levels 3, 4 & 5 trauma center facilities collectively lacked dose reduction strategies (0% vs. 25-57%), tended to have higher mAs (169 ± 113 vs. 110 ± 36), and were later adopters of dose reduction strategies on the CT scanners. There was more than a 10-fold variation in estimated median effective dose for a baby within level 4 trauma center facilities (3.5 ± 0.84 mSv, range 0.60 to 9.60 mSv).
There is both within and between trauma center level variation in pediatric head CT imaging protocols and radiation dose in Washington state.
研究华盛顿州儿科创伤性头部 CT 成像方案的变化。
对华盛顿州指定创伤的医院进行了一项基于网络的调查。调查对象被询问了儿科头部创伤量、CT 扫描仪类型以及 CT 成像方案的技术信息。研究了不同创伤中心级别之间儿科创伤量、CT 剂量降低策略和有效剂量的差异。估计了女性婴儿的头部有效剂量和器官剂量。
我们的总体回复率达到了 76%。在接受头部 CT 扫描的 2215 名儿童中，36.3%（n=805）在 4 级创伤中心接受头部 CT 成像，其次是 1 级创伤中心（31.4%；n=695）、3 级创伤中心（19.7%；n=436）、2 级创伤中心（12%；n=267）和 5 级（0.5%；n=12）设施。大多数参与调查的创伤中心（44/47）报告说有专门的儿科头部 CT 成像方案。然而，与 1 级和 2 级创伤中心相比，更多的 3 级、4 级和 5 级创伤中心联合起来缺乏剂量降低策略（0%比 25-57%），倾向于使用更高的 mAs（169±113 比 110±36），并且是 CT 扫描仪剂量降低策略的后来采用者。在 4 级创伤中心内，婴儿的估计中位有效剂量差异超过 10 倍（3.5±0.84 mSv，范围 0.60 至 9.60 mSv）。
华盛顿州的儿科头部 CT 成像方案和辐射剂量存在创伤中心内和创伤中心之间的差异。
