Suppr超能文献

儿科创伤患者行头部 CT 扫描的辐射剂量差异。

Variation in radiation dosing among pediatric trauma patients undergoing head computed tomography scan.

机构信息

From the Division of Pediatric Surgery (M.J.L., R.S., S.O., D.B.), Children's Hospital Los Angeles; Department of Surgery (M.J.L., R.S., S.O., D.B.), Keck School of Medicine, University of Southern California; Division of Pediatric Surgery (M.A., C.J.G., M.B.-D.) and Department of Radiology (L.L., P.S.), Children's Hospital Los Angeles; Department of Radiology (L.L., P.S.), Keck School of Medicine, University of Southern California; and Division of Emergency and Transport Medicine (P.P.C.), Children's Hospital Los Angeles, California.

出版信息

J Trauma Acute Care Surg. 2021 Sep 1;91(3):566-570. doi: 10.1097/TA.0000000000003318.

Abstract

BACKGROUND

When head injured children undergo head computed tomography (CT), radiation dosing can vary considerably between institutions, potentially exposing children to excess radiation, increasing risk for malignancies later in life. We compared radiation delivery from head CTs at a level 1 pediatric trauma center (PTC) versus scans performed at referring adult general hospitals (AGHs). We hypothesized that children at our PTC receive a significantly lower radiation dose than children who underwent CT at AGHs for similar injury profiles.

METHODS

We retrospectively reviewed the charts of all patients younger than 18 years who underwent CT for head injury at our PTC or at an AGH before transfer between January 1 and December 31, 2019. We analyzed demographic and clinical data. Our primary outcome was head CT radiation dose, as calculated by volumetric CT dose index (CTDIvol) and dose-length product (DLP; the product of CTDIvol and scan length). We used unadjusted bivariate and multivariable linear regression (adjusting for age, weight, sex) to compare doses between Children's Hospital Los Angeles and AGHs.

RESULTS

Of 429 scans reviewed, 193 were performed at our PTC, while 236 were performed at AGHs. Mean radiation dose administered was significantly lower at our PTC compared with AGHs (CTDIvol 20.3/DLP 408.7 vs. CTDIvol 30.6/DLP 533, p < 0.0001). This was true whether the AGH was a trauma center or not. After adjusting for covariates, findings were similar for both CTDIvol and DLP. Patients who underwent initial CT at an AGH and then underwent a second CT at our PTC received less radiation for the second CT (CTDIvol 25.6 vs. 36.5, p < 0.0001).

CONCLUSIONS

Head-injured children consistently receive a lower radiation dose when undergoing initial head CT at a PTC compared with AGHs. This provides a basis for programs aimed at establishing protocols to deliver only as much radiation as necessary to children undergoing head CT.

LEVEL OF EVIDENCE

Care Management/Therapeutic, level IV.

摘要

背景

当头部受伤的儿童接受头部计算机断层扫描(CT)时,不同机构之间的辐射剂量可能有很大差异,这可能会使儿童暴露于过量的辐射下,增加日后患恶性肿瘤的风险。我们比较了一级儿科创伤中心(PTC)和转诊成人综合医院(AGH)进行的头部 CT 检查的辐射剂量。我们假设,在我们的 PTC 接受 CT 的儿童比在 AGH 接受 CT 的儿童接受的辐射剂量明显更低,因为这些儿童的损伤情况相似。

方法

我们回顾性地审查了 2019 年 1 月 1 日至 12 月 31 日期间,在我们的 PTC 或在转至 AGH 之前进行的所有 18 岁以下头部受伤患者的 CT 检查的图表。我们分析了人口统计学和临床数据。我们的主要结果是头部 CT 辐射剂量,由容积 CT 剂量指数(CTDIvol)和剂量长度乘积(DLP;CTDIvol 和扫描长度的乘积)计算得出。我们使用未调整的双变量和多变量线性回归(根据年龄、体重、性别进行调整)来比较儿童洛杉矶医院和 AGH 之间的剂量。

结果

在 429 次扫描中,193 次在我们的 PTC 进行,而 236 次在 AGH 进行。与 AGH 相比,我们的 PTC 进行的平均辐射剂量明显较低(CTDIvol 20.3/DLP 408.7 与 CTDIvol 30.6/DLP 533,p <0.0001)。无论 AGH 是否为创伤中心,都是如此。在调整了协变量后,CTDIvol 和 DLP 的结果均相似。在 AGH 进行首次 CT 检查然后在我们的 PTC 进行第二次 CT 检查的患者,第二次 CT 检查的辐射剂量较低(CTDIvol 25.6 与 36.5,p <0.0001)。

结论

与在 AGH 进行初始头部 CT 检查相比,头部受伤的儿童在 PTC 进行头部 CT 检查时始终接受较低的辐射剂量。这为旨在制定仅向接受头部 CT 检查的儿童提供必要辐射剂量的方案提供了依据。

证据水平

治疗管理/治疗,IV 级。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验