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英国全国儿科 CT 检查剂量审计的分析和结果。

Analysis and results from a UK national dose audit of paediatric CT examinations.

机构信息

NHS Tayside, Dundee, United Kingdom.

Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom.

出版信息

Br J Radiol. 2022 Jan 1;95(1129):20210796. doi: 10.1259/bjr.20210796. Epub 2021 Nov 19.

Abstract

OBJECTIVE

To present the results following a UK national patient dose audit of paediatric CT examinations, to propose updated UK national diagnostic reference levels (DRLs) and to analyse current practice to see if any recommendations can be made to assist with optimisation.

METHODS

A UK national dose audit was undertaken in 2019 focussing on paediatric CT examinations of the head, chest, abdomen/pelvis and cervical spine using the methods proposed by the International Commission on Radiological Protection. The audit pro-forma contained mandatory fields, of which the post-examination dosimetry (volume CT dose index and dose-length product) and the patient weight (for body examinations) were the most important.

RESULTS

Analysis of the data submitted indicates that it is appropriate to propose national DRLs for CT head examinations in the 0-<1, 1-<5, 5-<10 and 10-<15 year age ranges. This extends the number of age categories of national DRLs from those at present and revises the existing values downwards. For CT chest examinations, it is appropriate to propose national DRLs for the first time in the UK for the 5-<15, 15-<30, 30-<50 and 50-<80 kg weight ranges. There were insufficient data received to propose national DRLs for abdomen/pelvis or cervical spine examinations. Recommendations towards optimisation focus on the use of tube current (mA) modulation, iterative reconstruction and the selection of examination tube voltage (kV).

CONCLUSION

Updated UK national DRLs are proposed for paediatric CT examinations of the head and chest.

ADVANCES IN KNOWLEDGE

A national patient dose audit of paediatric CT examinations has led to the proposal of updated national DRLs.

摘要

目的

介绍英国全国范围内对儿科 CT 检查的患者剂量审核结果,提出更新的英国国家诊断参考水平(DRLs),并分析当前的实践情况,以确定是否可以提出任何建议来协助优化。

方法

2019 年,英国进行了一项全国性剂量审核,重点是使用国际辐射防护委员会提出的方法对儿童头部、胸部、腹部/骨盆和颈椎进行 CT 检查。审核表格包含强制性字段,其中最重要的是检查后的剂量测定(容积 CT 剂量指数和剂量长度乘积)和患者体重(用于身体检查)。

结果

提交数据的分析表明,提出 0-<1、1-<5、5-<10 和 10-<15 岁年龄组 CT 头部检查的国家 DRL 是合适的。这扩展了国家 DRL 的年龄类别,并向下修订了现有值。对于 CT 胸部检查,首次在英国提出 5-<15、15-<30、30-<50 和 50-<80 公斤体重范围内的国家 DRL 是合适的。收到的腹部/骨盆或颈椎检查数据不足以提出国家 DRL。优化建议侧重于管电流(mA)调制、迭代重建和检查管电压(kV)的选择。

结论

提出了更新的英国国家儿童 CT 头部和胸部检查 DRL。

知识进展

对儿科 CT 检查的全国性患者剂量审核导致了更新的国家 DRL 的提出。

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