Department of Radiology, College of Health sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Ethiop J Health Sci. 2022 Mar;32(2):359-368. doi: 10.4314/ejhs.v32i2.17.
Overutilization of advanced diagnostic imaging modalities strains health care systems, especially in resource limited setups. The aim of this study is to identify magnitude of inappropriate Head Computed Tomography scans at Tikur Anbessa Specialized Hospital.
Retrospective cross-sectional study was conducted at Tikur Anbessa Specialized Hospital, Radiology department, among patients getting Head Computed Tomography examinations in the period of August 2018- November 2018. Appropriateness of each scan was assessed using the American College of Radiology Appropriateness Criteria.
Of the 443 Head Computed Tomography scans assessed, 61.6% were done for male patients and the mean age of patients scanned is 35. Children younger than 14yrs of age constituted 17.2%. No contrast was used in 63.9% of the scans and 64.3% were initial imaging with no prior study for similar indication. Out of the scans evaluated, 11.7% were inappropriate. Headache (38.5%), Seizure (23.1%) and Head trauma (23.1%) were the commonest indications for inappropriate scan. Scans done for cerebrovascular disease were 240 times more likely to be appropriate. Large number of inappropriate scans were requested from central triage (33.3%) and adult emergency (26.2%). Pediatric department requested inapproprieate scans in 11.9% of the cases. Residents requested majority of inappropriate scans (82.3%). Inappropriateness was associated with use of contrast agent and having only incidental outcomes.
A large number of inappropriate Head Computed Tomography scans are being done. Mechanisms such as preauthorization by radiologists, increasing awareness by medical students, physicians, radiology residents and radiologists and preparing customized imaging appropriateness guidelines should be implemented.
过度使用先进的诊断成像方式会给医疗保健系统带来压力，尤其是在资源有限的情况下。本研究旨在确定提克里特安巴塞特种医院过度使用头部计算机断层扫描的程度。
本回顾性横断面研究在提克里特安巴塞特种医院放射科进行，研究对象为 2018 年 8 月至 11 月期间进行头部计算机断层扫描检查的患者。使用美国放射学院适宜性标准评估每个扫描的适宜性。
在评估的 443 例头部计算机断层扫描中，61.6%的患者为男性，患者的平均年龄为 35 岁。17.2%的患者为 14 岁以下的儿童。63.9%的扫描未使用造影剂，64.3%为初始成像，无类似适应证的先前研究。在评估的扫描中，11.7%为不适当。头痛（38.5%）、癫痫（23.1%）和头部创伤（23.1%）是不适当扫描的常见指征。用于脑血管疾病的扫描被认为是合适的 240 倍。来自中央分诊（33.3%）和成人急诊（26.2%）的大量不适当扫描请求。儿科部门在 11.9%的情况下请求了不适当的扫描。住院医师请求了大多数不适当的扫描（82.3%）。不适当与使用造影剂和仅有偶然结果有关。
大量的头部计算机断层扫描是不适当的。应实施诸如放射科医生预先授权、提高医学生、医生、放射科住院医生和放射科医生的意识以及制定定制的成像适宜性指南等机制。
