Takahashi Edwin A, Yoon Hyo-Chun
John A. Burns School of Medicine at the University of Hawaii, 651 Ilalo Street Honolulu, HI 96813, USA.
Radiol Res Pract. 2013;2013:482403. doi: 10.1155/2013/482403. Epub 2013 Jul 28.
Purpose. The objective of this study was to determine the estimated effective radiation dose of pulmonary CT angiography (CTA) for suspected pulmonary embolism (PE) contributing to total medical radiation exposure over a 4-year period. Materials and Methods. This investigation retrospectively reviewed 300 patients who presented to the emergency department and received a pulmonary CTA scan for suspected PE. We evaluated these patients' electronic medical record to determine their estimated radiation exposure to CT scans during the following four years. Using DLP to E conversion coefficients, we calculated the cumulative effective radiation dose each subject received. Results. A total of 900 CT scans were reviewed in this study. Pulmonary CTA delivered an average effective radiation dose of 10.7 ± 2.5 mSv and accounted for approximately 65% of subjects' 4-year cumulative medical radiation dose. Only 6.3% of subjects had a positive acute PE according to their radiology report. Conclusion. Pulmonary CTA accounted for the majority of subjects' medically related effective radiation dose over a 4-year period. With only a minority of subjects having positive findings for acute PE, increased efforts should be made to clinically assess pretest probability before the consideration of imaging.
目的。本研究的目的是确定疑似肺栓塞(PE)患者进行肺部CT血管造影(CTA)的估计有效辐射剂量,以及其在4年期间对总体医疗辐射暴露的贡献。材料与方法。本调查回顾性分析了300例因疑似PE到急诊科就诊并接受肺部CTA扫描的患者。我们评估了这些患者的电子病历,以确定他们在接下来四年中接受CT扫描的估计辐射暴露量。使用剂量长度乘积(DLP)到有效剂量(E)的转换系数,我们计算了每个受试者接受的累积有效辐射剂量。结果。本研究共审查了900次CT扫描。肺部CTA的平均有效辐射剂量为10.7±2.5 mSv,约占受试者4年累积医疗辐射剂量的65%。根据放射学报告,只有6.3%的受试者急性PE呈阳性。结论。在4年期间,肺部CTA占受试者与医疗相关的有效辐射剂量的大部分。由于只有少数受试者急性PE检查结果呈阳性,因此在考虑进行影像学检查之前,应加大力度进行临床前概率评估。