新型冠状病毒肺炎疫情期间医患全程无接触胸部CT检查方法的探讨

Study on the Method of No-Contact Operation During Chest CT Examination of COVID-19

目的探讨在不改变CT检查设备原有结构和功能的前提下,实现安全、高效、快捷地全程无接触完成CT检查的方法,为新型冠状病毒肺炎疫情期间CT操作技师和相关人员院内交叉感染防控提供新的手段。方法本研究首先通过标准CT扫描模体,对来自不同厂家的三大类型CT扫描设备进行研究,确定胸部CT扫描定位参数,并对无接触扫描过程进行模拟和实现,制定无接触胸部CT检查流程。同时纳入2020年1月17日至2020年2月19日期间我院发热门诊来源胸部CT检查患者进行检查,进一步验证无接触胸部CT扫描的可行性。结果 1706例发热门诊患者中,本研究共纳入1531例患者进行了胸部CT检查,其中男性820名,女性720名,平均年龄(30±15)岁,无接触扫描完成检查率89.7%,所有图像均符合质控标准与诊断要求。在无接触扫描患者中,有8例因屏气不佳进行了补扫,补扫率0.52%;有13例因床位高度不佳和卧姿倾斜导致扫描图像部分超出显示范围,通过补重建进行了纠正,补重建率0.85%。结论本研究在不改动设备硬件的情况下,通过对不同类型设备进行精细定位方法实验,可实现无接触胸部CT扫描操作。在保证患者安全的前提下得到了满足诊断的图像最大程度降低了技师被感染和发生院内交叉感染的风险。

Objective To explore a safe and efficient no-contact method for Chest CT examination on the premise of not changing the original structure and function of the CT examination equipment,so as to provide a new method for the prevention and control of the cross infection in the hospital of CT operators and related personnel during the coronavirus disease 2019 epidemic.Methods A Standard CT scan phantom was scanned on three types of CT scanning equipment from different manufacturers to determine the chest CT scan positioning parameters,and to simulate and realize the no-contact scanning process.The no-contact operation process was formulated and optimized.Patients from fever clinic of our hospital from January 17,2020 to February 19,2020 were included for examination to further verify the feasibility of no-contact chest CT scan.Results In this study,a total of 1531 patients among 1706 patients with fever were enrolled for chest CT examination,including 820 males and 720 females,with an average age of(30±15)years old.The no-contact CT examination rate was 89.7%.All the images were diagnostic.There were 8 patients with poor breath-holding who underwent rescan,the rescan rate was 0.52%.In 13 cases,the scan image was out of the display range and was corrected by supplementary reconstruction due to the poor bed height and lying position tilt;the supplementary reconstruction rate was 0.85%.Conclusion By performing fine positioning experiments on different types of equipment we realized the no-contact chest CT scan without changing the hardware.This method minimizes the risk of technician infection and hospital cross-infection on the premise of ensuring the safety of the patients while obtaining the diagnostic images.