National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria.
Eur Radiol. 2013 Mar;23(3):623-31. doi: 10.1007/s00330-012-2639-3. Epub 2012 Sep 1.
To survey procedures and protocols in paediatric computed tomography (CT) in 40 less resourced countries.
Under a project of the International Atomic Energy Agency, 146 CT facilities in 40 countries of Africa, Asia, Europe and Latin America responded to an electronic survey of CT technology, exposure parameters, CT protocols and doses.
Modern MDCT systems are available in 77 % of the facilities surveyed with dedicated paediatric CT protocols available in 94 %. However, protocols for some age groups were unavailable in around 50 % of the facilities surveyed. Indication-based protocols were used in 57 % of facilities. Estimates of radiation dose using CTDI or DLP from standard CT protocols demonstrated wide variation up to a factor of 100. CTDI(vol) values for the head and chest were between two and five times those for an adult at some sites. Sedation and use of shielding were frequently reported; immobilisation was not. Records of exposure factors were kept at 49 % of sites.
There is significant potential for improvement in CT practice and protocol use for children in less resourced countries. Dose estimates for young children varied widely. This survey provides critical baseline data for ongoing quality improvement efforts by the IAEA.
调查 40 个资源较少国家儿科计算机断层扫描(CT)的程序和方案。
在国际原子能机构的一个项目下,来自非洲、亚洲、欧洲和拉丁美洲 40 个国家的 146 个 CT 设施对 CT 技术、曝光参数、CT 方案和剂量进行了电子调查。
在所调查的设施中,77%配备了现代 MDCT 系统,94%配备了专门的儿科 CT 方案。然而,在大约 50%的被调查设施中,一些年龄组的方案不可用。基于适应证的方案在 57%的设施中使用。使用标准 CT 方案的 CTDI 或 DLP 估算的辐射剂量差异很大,最高可达 100 倍。在一些部位,头部和胸部的 CTDI(vol)值是成人的 2 到 5 倍。经常报告镇静和使用屏蔽,但很少报告固定。只有 49%的站点记录了曝光因素。
资源较少国家的儿童 CT 实践和方案应用有很大的改进空间。对幼儿的剂量估计差异很大。这项调查为国际原子能机构正在进行的质量改进工作提供了关键的基线数据。