目的:我们与原子能机构协调的国际研究的目的是评估几个非洲国家多家医院的CT做法和辐射剂量。
方法:该研究包括来自非洲的13家医院,这些医院提供了至少20名连续接受头颅手术的患者的信息,胸部,和/或腹部骨盆CT。在数据记录步骤之前,所有医院都接受了1小时的强制性培训,内容涉及记录相关数据要素的最佳实践.记录的数据元素包括患者年龄,体重,协议名称,扫描仪信息,采集参数,和辐射剂量描述符,包括特定阶段的CT剂量指数体积(CTDIvolinmGy)和剂量长度乘积(DLPinmGy。cm)。我们估计了身体区域特异性CTDIvol和DLP的中位数和四分位数范围,并使用非正态分布的Kruskal-WallisH检验比较了不同地点和国家的数据,方差分析。
结果:共1061例患者(平均年龄50±19岁)纳入研究。16%的CT检查没有明确的头部CT检查的临床指征(32/343,9%),胸部(50/281,18%),腹部骨盆(67/243,28%),和/或胸腹部骨盆CT(24/194,12%)。大多数医院使用腹部骨盆(9/11医院)和胸部CT(10/12医院)的多相CT方案,无论临床适应症如何。头部总DLP中值(953mGy。cm),胸部(405毫克。cm),和腹部骨盆(1195mGy。cm)CT高于英国,德语,和美国放射学会诊断参考水平(DRL)。
结论:关于非洲几家医院的CT实践和方案的差异,强调需要更好的方案优化,以提高患者的安全。
OBJECTIVE: The objective of our IAEA-coordinated international
study was to assess CT practices and radiation doses from multiple hospitals across several African countries.
METHODS: The
study included 13 hospitals from Africa which contributed information on minimum of 20 consecutive patients who underwent head, chest, and/or abdomen-pelvis CT. Prior to the data recording step, all hospitals had a mandatory one-hour training on the best practices in recording the relevant data elements. The recorded data elements included patient age, weight, protocol name, scanner information, acquisition parameters, and radiation dose descriptors including phase-specific CT dose index volume (CTDIvol in mGy) and dose length product (DLP in mGy.cm). We estimated the median and interquartile range of body-region specific CTDIvol and DLP and compared data across sites and countries using the Kruskal-Wallis H Test for non-normal distribution, analysis of variance.
RESULTS: A total of 1061 patients (mean age 50 ± 19 years) were included in the
study. 16 % of CT exams had no stated clinical indications for CT examinations of the head (32/343, 9 %), chest (50/281, 18 %), abdomen-pelvis (67/243, 28 %), and/or chest-abdomen-pelvis CT (24/194, 12 %). Most hospitals used multiphase CT protocols for abdomen-pelvis (9/11 hospitals) and chest CT (10/12 hospitals), regardless of clinical indications. Total median DLP values for head (953 mGy.cm), chest (405 mGy.cm), and abdomen-pelvis (1195 mGy.cm) CT were above the UK, German, and American College of Radiology Diagnostic Reference Levels (DRLs).
CONCLUSIONS: Concerning variations in CT practices and protocols across several hospitals in Africa were demonstrated, emphasizing the need for better protocol optimization to improve patient safety.