儿童CT扫描参数的现状分析

Scanning parameters analysis on pediatric CT examination

目的：了解目前医院儿童CT检查与X射线辐射相关的扫描参数调节和适应证掌控情况.方法：抽取3类有代表性医院的儿童CT检查病人,其中医院甲（儿科诊疗特色较强的医院）54 例、医院乙（儿科与其他学科均衡的医院）50例、医院丙（以成人学科较强的医院）195例.将病例分成3个年龄组：0～3岁、4～7岁、8～14岁.比较三类医院不同年龄组的mAs与kVp的参数选择,通过统计阴性诊断结果来推断儿童CT适应证的使用尺度.结果：在299例CT检查儿童中,诊断结果为阴性的有155例,占调查例数51.8%.有儿童病房的医院采用的儿童CT头部扫描mAs低于没有儿童病房的医院,存在显著性差异,但是没有根据年龄特点来调整CT的曝光量.结论：儿童CT检查的阴性诊断率偏高,有儿童病房的医院临床医生的辐射防护意识较强,但还有待于进一步加强.

Objective：To investigate whether adjustments related to patients age were made in the scanning parameters （mAs and kVp） that are detemainants of radiation dose for multislice CT in pediatric patients and evaluate the indication of the pediatric CT examinations according to negative diagnosis.Methods：Two hundred and ninety-nine patients from 3 typical hospitals [ pediatric hospital （ Ⅰ ）, general hospital with pediatric department （ Ⅱ ）, and adults hospital without pediatric department （ Ⅲ ） were divided into three groups on the basis of individual＇ s age： group A（0 - 3 years） ,group B（4 - 8 years） and group C（9 - 14 years） ; The mAs, kVp and diagnosis results are analysed.Results：51.8% of diagnosis results were negative. We found no evident of adjustment in mAs and kVp based on the ages of patients. The scan parameter mAs in hospital （ Ⅲ ） was significandy higher than that in hospital Ⅰ and hospital Ⅱ . Condusion：① Fifty one paint eight percent negative diagnosis results showed that the indication of pediatric CT examination was not strictly managed. ②Pediatrie multisliee CT parameters （mAs and kVp） on head scan were not adjusted on the basis of the age of the children. Adults hospital need to improve scan parameters and reduce the radiation dose of pediatric CT examination.