Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Department of Radiation Therapy, West German Cancer Center Essen, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Department of Diagnostic and Interventional Radiology, Neuroradiology, Asklepios Klinikum Harburg, Hamburg, Germany.
Dtsch Arztebl Int. 2023 Mar 13;120(9):135-141. doi: 10.3238/arztebl.m2022.0395.
Computed tomography (CT) studies are requested by specialists from most medical disciplines and play a vital role in the diagnosis and treatment of patients. It follows that physicians of all specialties should possess basic knowledge of computed tomography, its proper use, and the radiation exposure associated with it.
This review is based on publications retrieved by a selective search of the literature.
Approximately 12 million CT studies are carried out in Germany each year, and the trend is rising. Approximately 9% of all diagnostic studies involving ionizing radiation are CT studies. On average, more than 60% of the collective effective dose due to medical radiation exposure is attributable to CT. There are two types of radiation effects caused by ionizing radiation: sto - chastic and deterministic. The additional, individual relative lifetime cancer mortality risk due to ionizing radiation with wholebody exposure at a low single dose is estimated at 5% per sievert. Radiation exposure from CT studies of the head and trunk, e.g. of a patient with polytrauma, corresponds to an additional lifetime cancer mortality risk of approximately 0.1% at an effective dose of approximately 20 millisievert.
The radiation exposure due to CT, and the risks to which patients are subjected by it, have become more important with greater use of CT. Technical advances, targeted dose monitoring, and analyses of dose data can help identify areas where improvement is necessary, in furtherance of the overriding goal of lowering patients' radiation exposure while preserving adequate image quality.
计算机断层扫描（CT）研究由大多数医学专业的专家提出，在患者的诊断和治疗中起着至关重要的作用。因此，所有专业的医生都应该具备 CT 的基本知识、正确使用方法以及相关的辐射暴露知识。
本综述基于文献检索的选择性搜索出版物。
德国每年进行约 1200 万次 CT 研究，且呈上升趋势。所有涉及电离辐射的诊断研究中，约有 9%是 CT 研究。平均而言，由于医疗辐射暴露，集体有效剂量的 60%以上归因于 CT。电离辐射会引起两种类型的辐射效应：随机效应和确定性效应。全身低单次剂量照射时，因电离辐射导致的额外个体相对终生癌症死亡率风险估计为每西弗特 5%。头部和躯干 CT 研究（例如多发伤患者）的辐射暴露，在有效剂量约为 20 毫西弗特时，相当于额外的终生癌症死亡率风险约为 0.1%。
随着 CT 的广泛应用，CT 带来的辐射暴露及其对患者的风险变得更加重要。技术进步、有针对性的剂量监测以及剂量数据分析可以帮助确定需要改进的领域，以实现降低患者辐射暴露同时保持足够图像质量的首要目标。
