Department of Diagnostic Radiology, Oulu University Hospital, 90029 OYS, Oulu, Finland.
Br J Radiol. 2013 Sep;86(1029):20130337. doi: 10.1259/bjr.20130337. Epub 2013 Aug 9.
To determine whether the justification of CT examinations performed on young patients can be improved by various interventions and whether these have an effect on the total number of CTs performed.
Specific interventions-education, guideline implementation and increased MRI capacity-were introduced at the Oulu University Hospital, Oulu, Finland, following a previous study demonstrating unjustified use of CT examination in young patients. In the present study, the justification of 177 CT examinations of the lumbar and cervical spine, head, abdomen, nasal sinuses and trauma performed on patients aged under 35 years in 2009 was analysed retrospectively by looking at requests and corresponding patient files. The indications of the examinations were compared with the referral guidelines recommended by the European Commission. Results from our previously published similar study carried out before the interventions were used as a reference.
The proportion of justified CT examinations increased from 71% (141/200) in 2005 to 87% (154/177) in 2009 (p<0.001), and in the lumbar spine group from 23% (7/30) to 81% (22/27) (p<0.001). In the case of most of the unjustified examinations, MRI could have been performed instead. The total number of CT examinations carried out on young patients decreased by 7% (p=0.012) and in the lumbar spine group by 79% (p<0.001).
The implemented interventions decreased the number of CT examinations performed on young patients, and the justification of the examinations improved significantly.
This study demonstrates that it is possible to reduce the number of various CT examinations and to improve their justification in young patients by regular education, guideline implementation and increased MRI capacity.
确定通过各种干预措施是否可以提高对年轻患者进行的 CT 检查的正当性，并确定这些干预措施是否对所进行的 CT 检查总数产生影响。
在芬兰奥卢大学医院（Oulu University Hospital）进行了一项先前的研究，该研究表明对年轻患者进行的 CT 检查存在不合理使用的情况，此后，在该研究中引入了特定的干预措施（教育、实施指南和增加 MRI 能力）。在本研究中，回顾性地分析了 2009 年在年龄小于 35 岁的患者中进行的 177 次腰椎和颈椎、头部、腹部、鼻窦和创伤 CT 检查的请求和相应的患者病历，以评估其正当性。将这些检查的指征与欧洲委员会推荐的转诊指南进行了比较。使用我们之前发表的类似研究的结果作为参考，该研究是在干预措施实施之前进行的。
正当检查的比例从 2005 年的 71%（141/200）增加到 2009 年的 87%（154/177）（p<0.001），腰椎组从 23%（7/30）增加到 81%（22/27）（p<0.001）。对于大多数不合理的检查，本可以进行 MRI 检查。对年轻患者进行的 CT 检查总数减少了 7%（p=0.012），腰椎组减少了 79%（p<0.001）。
实施的干预措施减少了对年轻患者进行的 CT 检查数量，并显著提高了检查的正当性。
本研究表明，通过定期教育、实施指南和增加 MRI 能力，可以减少各种 CT 检查的数量，并提高年轻患者检查的正当性。
