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急性胰腺炎患者的计算机断层扫描辐射剂量:一家三级转诊医院的审计。

Radiation dose from computed tomography in patients with acute pancreatitis: an audit from a tertiary care referral hospital.

机构信息

Department of Radiodiagnosis and Imaging, Section of GE Radiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.

出版信息

Abdom Radiol (NY). 2020 May;45(5):1517-1523. doi: 10.1007/s00261-020-02408-7.

Abstract

BACKGROUND

There is a limited data on the radiation dose from computed tomography (CT) in patients with acute pancreatitis (AP). The present study evaluated the radiation dose from CT scans in patients with AP.

MATERIAL

A retrospective review of CT reports of patients with AP was conducted. The type of CT scan (non-contrast vs. single-phase vs. biphasic CT) was recorded. The mean number of CT scans and cumulative radiation dose was calculated. The indications and abnormalities on biphasic CT scans were recorded. The radiation doses between different types of the scan were compared.

RESULTS

495 CT studies in 351 patients were evaluated. In patients (n = 78, 22.2%) undergoing multiple CT scans, mean number of CT scans per patient and mean radiation dose were 2.64 ± 1.18 (range 2-9) and 24 ± 15 mSv (range 8.3-79.8 mSv), respectively. The mean radiation dose was significantly greater in patients with modified CT severity index ≥ 8 (n = 63) [25.08 mSv vs. 18.96 mSv, (P = 0.048)]. 61 (12.32%) biphasic scans were performed. A definite indication for a biphasic CT scan was identified in 20 (32.7%) patients. Arterial abnormalities were detected in 6 (9.8%) patients undergoing CT for defined indication. Mean radiation dose in this group was 13.26 ± 7.64 mSv (range 3.42-38.27 mSv) which was significantly greater than the single venous phase scan (7.96 ± 3.48 mSv, P < 0.001).

CONCLUSION

There is a potential for substantial radiation exposure from CT scans to patients with AP. Patients with severe AP and those undergoing biphasic scans have significantly higher radiation exposure. Hence, routine arterial phase acquisition should be avoided.

摘要

背景

有关急性胰腺炎(AP)患者 CT 检查的辐射剂量数据有限。本研究评估了 AP 患者 CT 扫描的辐射剂量。

材料

对 AP 患者的 CT 报告进行了回顾性分析。记录了 CT 扫描的类型(非增强扫描、单期扫描和双期扫描)。计算了平均 CT 扫描次数和累积辐射剂量。记录了双期 CT 扫描的适应证和异常情况。比较了不同类型扫描之间的辐射剂量。

结果

共评估了 351 例患者的 495 次 CT 检查。在接受多次 CT 扫描的患者(n=78,22.2%)中,每位患者的平均 CT 扫描次数和平均辐射剂量分别为 2.64±1.18(范围 2-9)和 24±15 mSv(范围 8.3-79.8 mSv)。改良 CT 严重指数≥8 的患者(n=63)的平均辐射剂量明显更高[25.08 mSv 比 18.96 mSv,(P=0.048)]。61 次(12.32%)进行了双期扫描。在 20 名(32.7%)有明确适应证的患者中发现了进行双期 CT 扫描的明确适应证。在因明确适应证而行 CT 检查的 6 名(9.8%)患者中发现了动脉异常。该组的平均辐射剂量为 13.26±7.64 mSv(范围 3.42-38.27 mSv),明显高于单静脉期扫描(7.96±3.48 mSv,P<0.001)。

结论

AP 患者 CT 扫描的辐射暴露量有很大的潜在风险。严重 AP 患者和接受双期扫描的患者的辐射暴露量明显更高。因此,应避免常规动脉期采集。

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