Spectrum Health Helen DeVos Children's Hospital, Grand Rapids, MI, USA.
J Am Coll Radiol. 2012 May;9(5):340-3. doi: 10.1016/j.jacr.2011.12.027.
The growing use of CT as a diagnostic imaging tool has led to increased concern over radiation dose, particularly in pediatric patients. The ALARA concept has been popularized in dose reduction. ALARA supports the use of low-dose, pediatric-specific protocols. Strict adherence to low-dose protocols can be challenging, particularly in a high-volume radiology department that scans both pediatric and adult patients. The aim of this study was to determine whether the relocation of pediatric radiologic services from a combined high-volume pediatric and adult hospital to a children's hospital improves compliance with adjusted lower CT exposure parameters and thus the estimated effective dose of radiation delivered to pediatric patients.
A retrospective review of abdominal and pelvic CT console dose and exposure parameter data on 495 patients from a combined pediatric and adult radiology department and subsequently 244 patients from a dedicated pediatric radiology department was performed. The console dose-length product was converted to estimated effective dose. Patients were divided into 1 of 8 weight categories for analysis.
A statistically significant decrease in the estimated effective dose for abdominal and pelvic CT studies was observed in all but one of the weight categories at the pediatric radiology department compared with the pediatric and adult radiology department.
Imaging pediatric patients in a dedicated pediatric imaging department with dedicated pediatric CT technologists may result in greater compliance with pediatric protocols and significantly reduced patient dose. Conversely, greater scrutiny of compliance with pediatric dose-adjusted CT protocols may be necessary for departments that scan both children and adults.
随着 CT 作为诊断成像工具的广泛应用，人们越来越关注辐射剂量，尤其是在儿科患者中。ALARA 理念已在剂量减少中得到推广。ALARA 支持使用低剂量、针对儿科的方案。严格遵守低剂量方案可能具有挑战性，特别是在扫描儿科和成人患者的高容量放射科部门。本研究旨在确定将儿科放射服务从综合的大容量儿科和成人医院转移到儿童医院是否能提高对调整后的较低 CT 暴露参数的依从性，从而降低向儿科患者提供的辐射有效剂量。
对来自综合儿科和成人放射科部门的 495 名患者和随后来自专门的儿科放射科部门的 244 名患者的腹部和盆腔 CT 控制台剂量和曝光参数数据进行回顾性审查。控制台剂量-长度乘积被转换为估计的有效剂量。患者按 8 个体重类别进行分析。
与儿科和成人放射科部门相比，在除一个体重类别外的所有体重类别中，儿科放射科部门的腹部和盆腔 CT 研究的估计有效剂量均显著降低。
在专门的儿科成像部门中，由专门的儿科 CT 技师对儿科患者进行成像，可能会提高对儿科方案的依从性，并显著降低患者的剂量。相反，对于同时扫描儿童和成人的部门，可能需要更严格地审查对儿科剂量调整的 CT 方案的遵守情况。
