| 温学新,姚杰,高林峰,姚玉华.上海市4家儿童医院的儿童CT剂量分析[J].中华放射医学与防护杂志,2023,43(2):124-130 |
| 上海市4家儿童医院的儿童CT剂量分析 |
| Analysis of CT doses to paediatric patients in four children's hospitals in Shanghai |
| 投稿时间：2022-09-23 |
| DOI：10.3760/cma.j.cn112271-20220923-00386 |
| 中文关键词: 儿童 CT扫描 辐射剂量 诊断参考水平 容积CT剂量指数 |
| 英文关键词:Children CT scan Radiation dose Diagnostic reference level Volume computed tomography dose index |
| 基金项目:上海市公共卫生体系建设三年行动计划优秀学科带头人计划（GWV-10.2-XD16）；上海市公共卫生重点学科建设计划项目（GWV-10.1-XK10） |
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| 中文摘要: |
| 目的 通过对上海市儿童CT扫描受检者剂量参数的调查，探讨上海地区儿童CT扫描剂量分布情况，并为建立上海地区儿童受检者CT检查诊断参考水平提供依据。方法 2021年在上海地区全部4家儿童医院开展儿童头颅、胸部、腹部CT扫描受检者剂量普查，调查对象按年龄0~、1~、5~、10~15岁分为4个年龄组，每个年龄组调查30例，收集受检者基本信息、CT扫描参数、容积CT剂量指数（CTDIvol）和剂量长度乘积（DLP）等剂量指标，分析同一部位不同年龄组之间和同一部位同一年龄组不同医院之间CTDIvol、DLP的差异。结果 头颅CT扫描时，0~、1~、5~、10~15岁组儿童CTDIvol和DLP的75%位数分别为25、25、28、43 mGy和402、477、504、752 mGy·cm；胸部CT扫描时，0~、1~、5~、10~15岁组儿童CTDIvol和DLP的75%位数分别为2.7、2.2、2.8、5.4 mGy和40、48、75、176 mGy·cm；腹部CT扫描时，0~、1~、5~、10~15岁组儿童CTDIvol和DLP的75%位数分别为4.9、4.4、8.2、12 mGy和106、131、273、471 mGy·cm。同一部位不同年龄组之间和同一部位同一年龄组不同医院之间CTDIvol和DLP差异均有统计学意义（头颅、胸部和腹部，CTDIvol：χ2=221.68、167.27、127.07，DLP：χ2=220.63、261.46、216.61；4个年龄组，CTDIvol：头颅χ2=30.46、38.39、25.21、73.04，胸部χ2=30.46、35.69、58.92、48.03，腹部χ2=66.58、41.62、48.93、67.38；DLP：头颅χ2=28.82、72.49、47.72、52.34，胸部χ2=28.82、35.95、50.66、41.64，腹部χ2=45.53、26.02、39.34、44.24，P <0.05）。结论 上海市4家儿童医院头颅、胸部、腹部CTDIvol和DLP的P75低于或接近国家标准和欧洲部分国家诊断参考水平，部分扫描部位的DLP较高，儿童CT扫描程序还有进一步优化的必要。 |
| 英文摘要: |
| Objective To study the distribution of CT doses to paediatric patients in Shanghai by investigating the CT dose parameters availiable in Shanghai's children's hospticals, and to provide the basis for establishing the diagnostic reference level for the paediatic patients subjected to CT scanning in Shanghai.Methods In 2021, a general survey was carried out of the CT doses to the head, chest and abdomen of the scanned paediatric patients in four children's hospitals in the municipality. The scanned paediatic patients were divided into four age groups of 0-, 1-, 5- and 10-15 years old, each with 30 subjects. The basic information were collected on the subjects, CT scanning parameters, volume CT dose index (CTDIvol) and dose length product (DLP). SPSS 16.0 was used to carry out statistical analysis of the differences in CTDIvol and DLP between different age groups at the same site and between different hospitals for the same age group at the same site.Results The 75th percentile values of CTDIvol and DLP for 0-, 1-, 5- and 10-15 age groups were 25, 25, 28, 43 mGy and 402, 477, 504, 752 mGy·cm, respectively, for head scanning; 2.7, 2.2, 2.8, 5.4 mGy and 40, 48, 75 and 176 mGy·cm for chest; and 4.9, 4.4, 8.2, 12 mGy and 106, 131, 273, 471 mGy·cm for abdomen. There were significant differences in CTDIvol and DLP between different age groups at the same site and between different hospitals for the same age group at the same site (head, chest and abdomen CTDIvol:χ2=221.68, 167.27, 127.07, DLP:χ2=220.63, 261.46, 216.61; for four age groups, CTDIvol:head χ2=30.46, 38.39, 25.21, 73.04, chest χ2=30.46, 35.69, 58.92, and 48.03, abdomen χ2=66.58, 41.62, 48.93, and 67.38; DLP:head χ2=28.82, 72.49, 47.72, 52.34, chest χ2=28.82, 35.95, 50.66, 41.64, abdomen χ2=45.53, 26.02 39.34, 44.24, P <0.05).Conclusions The 75th percentile values of CTDIvol and DLP for head, chest and abdomen in 4 children's hospitals in Shanghai are lower or close to the values given in the relevant national standards and the diagnostic reference levels in some European countries, with higher DLP values on some scanning sites. The CT scanning procedures for paediatric patients needs to be further optimized. |
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