Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington; Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington.
Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington; Department of Radiology, School of Medicine, University of Washington, Seattle, Washington.
J Am Coll Radiol. 2014 Feb;11(2):161-168.e3. doi: 10.1016/j.jacr.2013.07.004. Epub 2013 Dec 20.
To examine variation in pediatric trauma head CT imaging protocols in Washington State trauma centers (TCs) in 2012 and compare to a previous survey conducted in 2008-2009.
A mixed-mode (online and paper) survey was sent to all adult and pediatric Washington State TCs (levels 1-5). Respondents provided information about the CT scanner used for pediatric head scans and technical information about pediatric dose reduction protocols. Mean head effective dose and organ dose for a female baby were estimated. Results were compared with previous data.
Sixty-one of 76 TCs responded to the 2012 survey (response rate, 80.3%, versus 76% for 2008-2009 survey). In 2012, 91.7% reported having a dedicated pediatric protocol (87.7% in 2008-2009). Protective shielding use ranged from 80% to 100% across both survey years. In 2012, 2.5 times more TCs provided sufficient information to conduct dose calculations than in 2008-2009. Estimated mean CT dose index was 23.1 milliGray (mGy) in 2012, compared with 34.8 mGy in 2008-2009 (P = .01). Estimated mean dose length product was also significantly lower in 2012 than 2008-2009 (307.6 mGy × cm versus 430.1 mGy × cm, respectively; P = .04). Wide variation in mean effective dose was observed for level 3 and 4 TCs in 2012, similar to variation observed in 2008-2009 among level 4 TCs. Mean organ dose was significantly lower in 2012 for eye lens and brain, but higher for thyroid than in 2008-2009 (P < .05).
Although most Washington State TCs employ dose reduction protocols for pediatric head CTs, and some measures were lower in 2012, variation in protocols use and estimated dose continues to exist. More complete responses in 2012 suggest improved understanding of the importance of pediatric dose reduction efforts. Education and institutional protocols are necessary to reduce pediatric radiation dose from head CTs.
检查 2012 年华盛顿州创伤中心（TC）儿科创伤头部 CT 成像方案的变化，并与 2008-2009 年进行的先前调查进行比较。
采用混合模式（在线和纸质）调查向所有华盛顿州成人和儿科 TC（1-5 级）发送。受访者提供了用于儿科头部扫描的 CT 扫描仪的信息以及儿科剂量减少方案的技术信息。估计了女性婴儿的头部有效剂量和器官剂量。结果与以前的数据进行了比较。
在 2012 年，76 个 TC 中有 61 个对 2012 年的调查做出了回应（回应率为 80.3%，而 2008-2009 年的调查为 76%）。2012 年，91.7%的人报告说有专门的儿科方案（2008-2009 年为 87.7%）。在这两年的调查中，使用防护屏蔽的比例均在 80%至 100%之间。2012 年，提供足够剂量计算信息的 TC 数量是 2008-2009 年的两倍多。2012 年的平均 CT 剂量指数为 23.1 毫戈瑞（mGy），而 2008-2009 年为 34.8 mGy（P =.01）。2012 年的平均剂量长度乘积也明显低于 2008-2009 年（分别为 307.6 mGy×cm 和 430.1 mGy×cm；P =.04）。2012 年，3 级和 4 级 TC 的平均有效剂量存在很大差异，与 2008-2009 年 4 级 TC 之间的差异相似。2012 年，晶状体和大脑的平均器官剂量明显低于 2008-2009 年，但甲状腺的剂量高于 2008-2009 年（P <.05）。
尽管华盛顿州的大多数 TC 都为儿科头部 CT 采用了剂量减少方案，但 2012 年的一些措施有所降低，但方案使用和估计剂量的差异仍然存在。2012 年更完整的回复表明，人们对儿科剂量减少工作的重要性有了更好的理解。需要教育和机构方案来降低儿科头部 CT 的辐射剂量。
