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儿童 CT 脑检查的辐射剂量评估:多中心研究。

Radiation dose evaluation of pediatric patients in CT brain examination: multi-center study.

机构信息

Unité de Recherche de la Matière Condensée, d'Electronique et de Traitement du Signal, Department of Physics, Faculty of Science, University of Dschang, Dschang, Cameroon.

Department of Radiography, Yaoundé General Hospital, Yaoundé, Cameroon.

出版信息

Sci Rep. 2021 Feb 25;11(1):4663. doi: 10.1038/s41598-021-84078-z.

Abstract

There is currently no Pediatric Regulatory Diagnostic Reference Level (DRL) in Cameroon to standardize protocols in hospitals. France, a European country, has DRL allowing them to optimize their examination protocol. For the sake of radiation protection, we have proposed to evaluate the dose and acquisition parameters delivered to our pediatric patients to optimize the protocols used. We also compared the 75th percentile values of dose parameters by acquisition between the three hospitals to Diagnostic Reference Level (DRL) of France. In this retrospective and evaluative multicenter study, a total of 320 patients who had at least one cranial CT scan were enrolled from three medical centers. The CT acquisition parameters including tube potential (kV), tube current (mA), slice Thickness (T), spiral or sequential scanning techniques, volume CT dose index (CTDIvol), and dose length product (DLP) were analyzed. CTDIvol values in our centers were found up to 17.42%, 46.01%, 21.56% respectively for children aged 1-4 higher than values of France's DRL. For those aged 5-9, we obtained 44.58%, 43.15%, 42.21% respectively. In addition, for children aged 10-14 there are also up to 47.73%, 44.11%, 46.39% respectively higher than values of France's DRL. It is similary for DLP values. The study showed a significant dosimetric overshoot compared to the France's DRL and prompted us to make corrections to the protocols used and to a more rigorous monitoring of the principles of radiation protection and optimization rules in pediatric computed tomography in our hospitals. Our results have led us to make changes to our protocols which are the subject of a new dosimetric evaluation. The development of DRL for improving the pediatric CT scan in our country is necessary to optimize our protocols. Our results have led us to make changes to our protocols which are the subject of a new dosimetric evaluation. It would be necessary to set up a quality control structure in Cameroon and their applications in current practice.

摘要

目前,喀麦隆没有儿科监管诊断参考水平(DRL)来规范医院的协议。法国作为一个欧洲国家,有 DRL 允许他们优化检查协议。为了辐射防护,我们已经提出评估剂量和采集参数传递给我们的儿科患者,以优化使用的协议。我们还比较了三家医院之间通过采集获得的剂量参数的第 75 个百分位值与法国的诊断参考水平(DRL)。在这项回顾性和评估性多中心研究中,从三家医疗中心共纳入了 320 名至少进行过一次颅脑 CT 扫描的患者。CT 采集参数包括管电压(kV)、管电流(mA)、层厚(T)、螺旋或顺序扫描技术、容积 CT 剂量指数(CTDIvol)和剂量长度乘积(DLP)。我们中心的 CTDIvol 值分别为 1-4 岁儿童的 17.42%、46.01%、21.56%,高于法国 DRL 值。对于 5-9 岁的儿童,我们分别获得了 44.58%、43.15%、42.21%。此外,对于 10-14 岁的儿童,也分别有高达 47.73%、44.11%、46.39%高于法国 DRL 值。DLP 值也是如此。研究结果显示,与法国 DRL 相比,剂量测量存在显著超调,并促使我们对使用的协议进行修正,并更加严格地监测儿科计算机断层扫描的辐射防护原则和优化规则。我们的结果促使我们对协议进行修改,这是新的剂量学评估的主题。为了优化协议,有必要为我国儿科 CT 扫描制定 DRL。我们的结果促使我们对协议进行修改,这是新的剂量学评估的主题。有必要在喀麦隆建立一个质量控制结构,并将其应用于当前的实践中。

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