1185 例神经外科住院患者头 CT 影像学辐射负担的患者安全分析。
Patient Safety Analysis in Radiation Burden of Head Computed Tomography Imaging in 1185 Neurosurgical Inpatients.
机构信息
Department of Neurosurgery, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA.
Department of Neurosurgery, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Radiation Safety, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Physics & Biology in Medicine Graduate Program, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Radiology, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Radiological Sciences-Section of Neuroradiology, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Head and Neck Surgery, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Radiation Oncology, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Los Angeles Biomedical Research Institute, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Harbor-UCLA Medical Center, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA.
出版信息
World Neurosurg. 2020 Jan;133:e308-e319. doi: 10.1016/j.wneu.2019.09.004. Epub 2019 Sep 12.
OBJECTIVE
We performed a retrospective analysis in a cohort of 1185 patients at our institution who were identified as undergoing ≥1 head computed tomography (CT) examinations during their inpatient stay on the neurosurgery service, to quantify the number, type, and associated radiation burden of head CT procedures performed by the neurosurgery service.
METHODS
CT procedure records and radiology reports were obtained via database search and directly validated against records retrieved from manual chart review. Next, dosimetry data from the head CT procedures were extracted via automated text mining of electronic radiology reports.
RESULTS
Among 4510 identified adult head CT procedures, 88% were standard head CT examinations. A total of 3.65 ± 3.60 head CT scans were performed during an average adult admission. The most common primary diagnoses were neoplasms, trauma, and other hemorrhage. The median cumulative effective dose per admission was 5.66 mSv (range, 1.06-84.5 mSv; mean, 8.56 ± 8.95 mSv). The median cumulative effective dose per patient was 6.4 mSv (range, 1.1-127 mSv; mean, 9.26 ± 10.0 mSv).
CONCLUSIONS
The median cumulative radiation burden from head CT imaging in our cohort equates approximately to a single chest CT scan, well within accepted limits for safe CT imaging in adults. Refined methods are needed to characterize the safety profile of the few pediatric patients identified in our study.
目的
我们对本机构的 1185 名患者进行了回顾性分析，这些患者在神经外科住院期间接受了≥1 次头部计算机断层扫描（CT）检查，以量化神经外科服务所进行的头部 CT 检查的数量、类型和相关辐射负担。
方法
通过数据库搜索获取 CT 程序记录和放射学报告，并直接与从手动图表审查中检索到的记录进行验证。接下来，通过自动挖掘电子放射学报告中的文本提取头部 CT 程序的剂量数据。
结果
在 4510 次成人头部 CT 检查中，88%为标准头部 CT 检查。在成人平均住院期间，共进行了 3.65±3.60 次头部 CT 扫描。最常见的主要诊断是肿瘤、创伤和其他出血。每次入院的中位数累积有效剂量为 5.66 mSv（范围为 1.06-84.5 mSv；平均值为 8.56±8.95 mSv）。每位患者的中位数累积有效剂量为 6.4 mSv（范围为 1.1-127 mSv；平均值为 9.26±10.0 mSv）。
结论
在我们的队列中，头部 CT 成像的中位数累积辐射负担相当于单次胸部 CT 扫描，远低于成人安全 CT 成像的可接受范围。需要改进方法来描述我们研究中少数儿科患者的安全概况。
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