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评估创伤急诊科申请脑部CT扫描的必要性及辐射风险。

Evaluating the Necessity and Radiation Risk of Brain CT Scans Requested by the Trauma Emergency Department.

作者信息

Moradi Hadi, Chehre Hossein, Ghaderi Behzad, Saghatchi Faranak, Najafi Masoud, Karami Parisa, Rezaeejam Hamed

机构信息

Student Research Committee, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran.

Department of Biomedical Physics and Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

J Biomed Phys Eng. 2023 Dec 1;13(6):515-522. doi: 10.31661/jbpe.v0i0.2012-1251. eCollection 2023 Dec.

Abstract

BACKGROUND

Numerous Computed Tomography (CT) scan requests for trauma patients have raised serious concern about the impacts of radiation such as radiation-induced cancers.

OBJECTIVE

This study aimed to evaluate the necessity rate of requested head CT scans for traumatic patients and to ultimately estimate the risk of radiation-induced brain cancer.

MATERIAL AND METHODS

In this retrospective analytical study, traumatic patients, who had undergone a head CT scan in a two-month period from August 23 to October 22, 2018, were considered as the study population. Two radiologists reviewed each patient individually to evaluate the rate of normal and abnormal cases. Dose length product in milligrays (mGy) was utilized to calculate the effective dose (ED) in millisieverts (mSv), resulting in an assessment of the risk of radiation-induced brain cancer using ICRP 103.

RESULTS

Among 523 scans, 460 patients (88%) received normal reviews, while only 47 patients (9%) had findings related to their current trauma. The mean effective dose value was 1.05±0.36 mSv. Risk of the radiation induced brain cancer was calculated to be 0.037 and 0.030 new cancer cases in 10000 males and females per Gy, respectively.

CONCLUSION

Final results demonstrated that a significant number of traumatic patients undergoing a CT scan are in fact, healthy. Such reckless usage of CT and consequently the excess exposure could result in a dramatic rise in cancer rates. The need to limit unnecessary CT scan usage and keeping the radiation given to patients as low as reasonably achievable (ALARA) when collecting essential diagnostic data is more critical than ever.

摘要

背景

大量针对创伤患者的计算机断层扫描(CT)请求引发了人们对辐射影响(如辐射诱发癌症)的严重担忧。

目的

本研究旨在评估创伤患者头部CT扫描请求的必要性,并最终估计辐射诱发脑癌的风险。

材料与方法

在这项回顾性分析研究中,将在2018年8月23日至10月22日的两个月期间接受头部CT扫描的创伤患者作为研究对象。两名放射科医生分别对每位患者进行评估,以确定正常和异常病例的比例。使用以毫格雷(mGy)为单位的剂量长度乘积来计算以毫希沃特(mSv)为单位的有效剂量(ED),并根据国际放射防护委员会(ICRP)第103号出版物评估辐射诱发脑癌的风险。

结果

在523次扫描中,460名患者(88%)的检查结果正常,而只有47名患者(9%)有与当前创伤相关的检查结果。平均有效剂量值为1.05±0.36 mSv。计算得出,每格雷辐射诱发脑癌的风险在男性和女性中分别为每10000人中有0.037例和0.030例新发病例。

结论

最终结果表明,大量接受CT扫描的创伤患者实际上是健康的。这种对CT的滥用以及由此导致的过度辐射暴露可能会使癌症发病率急剧上升。在收集必要的诊断数据时,限制不必要的CT扫描使用并将给予患者的辐射剂量保持在合理可达到的最低水平(ALARA原则)比以往任何时候都更为关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7026/10749414/c256affd6852/JBPE-13-515-g001.jpg

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