Abstract：
A production facility shutdown related to containment measures during the COVID-19 pandemic has resulted in a global shortage of iodinated contrast media. This article describes the strategies implemented at one large U.S. health system to maintain care continuity during the ongoing shortage. The strategies have included attempts to procure additional stock, repackage existing stock for use in larger numbers of patients, use noncontrast CT or alternative imaging modalities in place of contrast-enhanced CT, and collaborate with specialties outside of radiology to participate in conservation efforts. In addition, individual CT protocols underwent tailored modifications to use dual-energy technique and/or lower tube voltages, to allow lower contrast media doses with maintained visualization of tissue enhancement. The experiences during this period provide insights to facilitate long-term reductions in contrast media doses and ongoing CT protocol optimization after supplies return to normal levels. Critical throughout the efforts to mitigate the impact of the shortage have been system-level action, operational flexibility, and close communication by the health system\'s radiologists, technologists, physicists, pharmacists, and ordering providers.
摘要：
在COVID-19大流行期间，与控制措施有关的生产设施关闭导致全球碘化造影剂短缺。本文介绍了在美国一个大型卫生系统中实施的策略，以在持续短缺期间保持护理连续性。这些策略包括试图购买额外的股票，重新包装现有库存，供更多患者使用，使用非对比CT或替代成像方式代替对比增强CT，并与放射学以外的专业合作，参与保护工作。此外,个别CT协议进行了量身定制的修改，以使用双能量技术和/或较低的管电压，允许较低的造影剂剂量，并保持组织增强的可视化。在此期间的经验提供了见解，以促进造影剂剂量的长期减少和在供应恢复到正常水平后正在进行的CT方案优化。在减轻短缺影响的整个努力中，关键是系统一级的行动，操作灵活性,以及卫生系统放射科医生的密切沟通，技术人员,物理学家,药剂师,和订购供应商。
