| 张薇,赵国胜,李超,等.临床急诊多部位CT检查阳性率分析及其正当性探讨[J].中华放射医学与防护杂志,2026,46(1):84-89.Zhang Wei,Zhao Guosheng,Li Chao,et al.Analysis of positive rates and justification of multi-site computed tomography examinations in clinical emergency settings[J].Chin J Radiol Med Prot,2026,46(1):84-89 |
| 临床急诊多部位CT检查阳性率分析及其正当性探讨 |
| Analysis of positive rates and justification of multi-site computed tomography examinations in clinical emergency settings |
| 投稿时间：2025-03-26 |
| DOI：10.3760/cma.j.cn112271-20250326-00112 |
| 中文关键词: 计算机体层成像 阳性率 辐射损伤 正当性 |
| 英文关键词:Computed tomography Positive rate Radiation injury Justification |
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| 中文摘要: |
| 目的 探讨急诊多部位CT检查的正当性,评估其是否符合放射实践正当化原则。方法 回顾性分析2024年7—12月义乌市中心医院放射科1 989例急诊多部位CT检查数据,统计人次与部位阳性率,对比不同年龄、检查部位数、申请科室及不同就诊原因的阳性率差异。结果 总部位阳性率为33.10%(2 423/7 321),显著低于国家要求的≥60%标准。其中,儿童(19.05%)及青少年(15.38%)阳性率显著低于成人的33.75%(χ2=24.56,P<0.05)。多部位扫描(≥6个部位)阳性率高达58.48%,显著高于其他组;急诊监护病区阳性率75.31%及神经系统病症阳性率57.36%均为最高(χ2=313.07,P<0.05)。阳性人数占比58.17%(1 157/1 989),但部位阳性率显著低于人次阳性率(χ2=415.70,P<0.001)。结论 急诊多部位CT检查阳性率普遍低于国家标准,辐射剂量与诊断获益失衡,存在过度检查风险,需强化正当化评估,以减少非必要辐射照射。 |
| 英文摘要: |
| Objective To explore the justification of emergency multi-site computed tomography (CT) examinations and to evaluate whether they conformed to the principle of justification in radiological practice. Methods A retrospective analysis was performed on data of 1 989 cases of emergency multi-site CT examinations in Yiwu Central Hospital from July to December 2024. The positive rates by person-time and by site were calculated, and differences in positive rates among patients of different age groups, patients with different numbers of examined sites, examinations requested by different departments, and reasons for presentation were compared. Results The overall positive rate by site was 33.10% (2 423/7 321), which was significantly lower than the national standard of ≥60%. The positive rates of children (19.05%) and adolescents (15.38%) were significantly lower than that of adults (33.75%) (χ2 = 24.56, P<0.05). The positive rate of multi-site (≥6) CT examinations was as high as 58.48%, significantly higher than those of other groups. The positive rate of CT examinations requested by the emergency intensive care unit (75.31%) and that for neurological disorders (57.36%) were highest among departments and reasons for presentation, respectively (χ2 = 313.07, P<0.05). The proportion of positive cases was 58.17% (1 157/1 989). The positive rate by site was significantly lower than the positive rate by person-time (χ2 = 415.70, P<0.001). Conclusions The positive rates of emergency multi-site CT examinations are generally lower than the national standard, with an imbalance between radiation dose and diagnostic benefits and a risk of over-examination. It is necessary to strengthen justification evaluation to reduce unnecessary radiation exposure. |
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