Sedlic Anto, Chingkoe Christina M, Tso David K, Galea-Soler Sandro, Nicolaou Savvas
Vancouver General Hospital, University of British Columbia, 899 West 12th Avenue, Vancouver, BC, Canada, V5Z 1M9,
Emerg Radiol. 2013 Oct;20(5):401-8. doi: 10.1007/s10140-013-1139-3. Epub 2013 Jun 21.
The purpose of this study is to determine whether a single acquisition whole-body trauma multi-detector CT scan is able to reduce resuscitation time, scan time, and effective radiation dose without compromising diagnostic quality in the setting of polytrauma. Retrospective analysis of 33 trauma patients undergoing single acquisition whole-body CT with injury severity scores of ≥ 16 was compared to 34 patients imaged with a segmented whole-body CT protocol. Time spent in the emergency department, effective radiation dose, image quality, and mortality rates were compared. The single acquisition group spent 53.7 % less time in the emergency department prior to imaging (p=0.0044) and decreased scanning time by 25 %. The protocol yielded a 24.5 % reduction in mean effective radiation dose (24.66 mSv vs. 32.67 mSv, p<0.0001). The image noise was similar in both groups. Standardized mortality ratios were comparable. The single acquisition protocol significantly reduces time spent in the emergency department by allowing faster imaging at a lower radiation dose while maintaining image quality. Other contributors to reduction in radiation dose include use of dual-source CT technology, removal of delayed CT intravenous pyelogram, and arm positioning.
本研究的目的是确定在多发伤情况下,单次采集的全身创伤多排CT扫描是否能够在不影响诊断质量的前提下,缩短复苏时间、扫描时间并降低有效辐射剂量。对33例损伤严重程度评分≥16且接受单次采集全身CT扫描的创伤患者进行回顾性分析,并与34例采用分段全身CT方案成像的患者进行比较。比较了在急诊科的停留时间、有效辐射剂量、图像质量和死亡率。单次采集组在成像前在急诊科的停留时间减少了53.7%(p = 0.0044),扫描时间缩短了25%。该方案使平均有效辐射剂量降低了24.5%(24.66 mSv对32.67 mSv,p < 0.0001)。两组的图像噪声相似。标准化死亡率相当。单次采集方案通过在较低辐射剂量下实现更快成像,同时保持图像质量,显著减少了在急诊科的停留时间。辐射剂量降低的其他因素包括使用双源CT技术、取消延迟CT静脉肾盂造影以及手臂定位。