| 张宗锐,康天良,李振涛,等.北京市成年人CT扫描辐射剂量和诊断参考水平的探讨[J].中华放射医学与防护杂志,2025,45(3):229-236.Zhang Zongrui,Kang Tianliang,Li Zhentao,et al.Exploration of radiation dose and diagnostic reference level for adult CT scans in Beijing[J].Chin J Radiol Med Prot,2025,45(3):229-236 |
| 北京市成年人CT扫描辐射剂量和诊断参考水平的探讨 |
| Exploration of radiation dose and diagnostic reference level for adult CT scans in Beijing |
| 投稿时间：2024-04-17 |
| DOI：10.3760/cma.j.cn112271-20240417-00140 |
| 中文关键词: CT 辐射剂量 诊断参考水平 可达到剂量 |
| 英文关键词:CT Radiation dose Diagnostic reference level Achievable dose |
| 基金项目:国家自然科学基金(82271988) |
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| 中文摘要: |
| 目的 通过对北京市部分医院成年人CT辐射剂量的调查,探讨北京市成年人的CT辐射剂量现状和诊断参考水平(DRL)。方法 2023年9月至12月在北京市调查50家医院,其中三级医院47家,二级医院3家。在状态检测合格的常用CT设备上收集颅脑逐层、颅脑螺旋、颅脑灌注、鼻窦、颈部、常规胸部、低剂量胸部、上腹部、盆腔、腹部盆腔联合扫描、胸腹盆联合扫描、腰椎、 CT尿路成像(CTU)、冠状动脉CT血管成像(CTA)、颅脑CTA、颈部CTA、主动脉CTA,双下肢CTA,膝关节共20个检查项目,每个项目每台设备连续随机采集最多50例辐射剂量数据。以容积CT剂量指数(CTDIvol)和剂量长度乘积(DLP)作为剂量参量,得到每家医院每个检查项目的中位数,各家医院的中位数按照大小排列,取75％位数为北京市本地DRL。将所得DRL与国内、国际相关放射防护组织发布的DRL进行比较。结果 共收集26 031个成年病例的CT辐射剂量数据,经逐一检查剔除35个无效数据,剩余25 996个有效数据。全市范围内不同的CT使用单位,同一检查项目的CTDIvol、DLP和扫描期相存在差异。CTDI最大的5种检查项目为颅脑灌注、颅脑逐层、颅脑螺旋、冠状动脉CTA(回顾性扫描方式)、鼻窦等,DLP最大的5种检查项目为CTU、颅脑灌注、双下肢CTA、胸腹盆腔连扫、主动脉CTA,其中CTU的CTDIvol虽然仅为16.9 mGy(75%位数),但DLP却高达2 394.9 mGy·cm(75%位数)。调查显示北京市大部分检查项目的DRL低于国内外国家级DRL,少部分检查项目的DRL略高于后者。结论 北京市当前的CT剂量水平与国内外发布的国家级DRL存在差异性,需要根据北京市的实际情况建立本地DRL。 |
| 英文摘要: |
| Objective To investigate the status and diagnostic reference levels (DRLs) of adult CT radiation dose based on survey result from some hospitals in Beijing. Methods From September to December 2023, the survey results for 50 hospitals were collected in Beijing, including 47 tertiary hospitals and 3 second grade general hospitals. The CT data sets in total of 20 items including head (sequential scanning), head (spiral scanning), head perfusion, sinus, neck, chest, chest (low dose scanning), abdomen, pelvis, abdomen-pelvis, chest-abdomen-pelvis, lumbar spine, CT urography, coronary CTA (retrospective), coronary CTA (prospective), head CTA, neck CTA, aorta CTA, leg CTA and knee were collected on clinical commonly used CT scanners with annual qualified state inspection. For each item, radiation dose data was collected continuously and randomly for up to 50 cases for every CT scanner. Using the volume CT dose index (CTDIvol) and dose length product (DLP) as dose parameters, the median value of each item in each hospital was obtained. The median CTDIvol and DLP values of all hospitals were arranged, and the local DRL of each item was set as the 75th percentile of the median values. The obtained DRLs were compared with the DRLs issued by domestic and international radiological protection organizations. Results A total of 26 031 dose values of adult patients were collected and 25 996 dose values were left while 35 invalid values removed.For different CT users, CTDlvol, DLP and scanning phases were different for the same item. The five items with the highest CTDI were head perfusion, head sequential scanning, head spiral scanning, coronary CTA (retrospective mode), and sinus. The five items with the highest DLP were CTU, head perfusion, leg CTA, chest-abdomen-pelvis and aortic CTA. The CTDIvol of CTU was only 16.9 mGy (75th percentile), while the DLP was as high as 2 394.9 mGy·cm (75th percentile). The survey showed that the DRLs of most items in Beijing was lower than the national DRLs of domestic and foreign standards, and the DRLs of a small number of items were slightly higher. Conclusion The current CT dose level in Beijing is not consistent with national DRLs released at home and abroad, so it is necessary to establish local DRLs according to the clinical status in Beijing. |
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