辽宁省2021—2022年医用数字X射线摄影质量控制检测结果分析

Analysis of quality control test results of medical digital radiography in Liaoning Province from 2021 to 2022

目的通过对辽宁省2021—2022年医用数字X射线摄影(DR)设备质量控制检测结果进行分析,初步掌握DR设备的质量现状,为医院加强DR设备质量管理提供参考。方法采用方便抽样方法,选择2021至2022年辽宁省59家医院在用的75台医用DR设备为研究对象,依据WS76—2020《医用X射线诊断设备质量控制检测规范》,采用相关设备对不同厂家DR设备的通用检测项目和专用检测项目进行检测,观察DR设备有无自动曝光控制(AEC)功能及损坏、是否可获取预处理图像及像素值。不同品牌设备通用检测项目和专用检测项目的检测指标间的比较采用独立样本t检验;不同品牌设备间检测指标的比较采用Kruskal-Wallis H检验。结果75台DR设备中,德国西门子公司占11%(8/75),上海联影医疗科技有限公司占38%(29/75),北京万东医疗科技股份有限公司占13%(10/75),沈阳东软医疗系统有限公司占7%(5/75),其他公司占31%(23/75)。DR通用检测项目检测的管电压指示偏离和光野与照射野四边偏离在其他公司中的合格率均为96%(22/23)。AEC重复性、AEC响应、AEC电离室之间一致性无法检测的设备占55%(41/75)。在专用检测项目中,测距误差在其他公司中的合格率为88%(15/17),其余检测项目的合格率均为100%。探测器剂量指示、信号传递特性、响应均匀性无法检测的设备占51%(38/75)。受检设备无测量工具导致测距误差无法测量的设备占15%(11/75)。高低对比度分辨力以本次调查结果作为基线值的设备占40%(30/75)。探测器剂量指示除了无法检出的设备,剩余设备以本次调查结果作为基线值占26%(10/38)。不同品牌设备通用检测项目检测指标和专用检测项目检测指标间的差异均无统计学意义(H=0.34~9.38,均P>0.05)。结论建议医院每年委托有资质的单位对DR设备进行状态检测,以便及时对其进行调试,确保DR设备的准确性;同时医院部分DR设备缺少检测功能和检测项目,卫生行政监督部门应尽快给出医院DR设备检测的标准,进一步重视DR设备质量控制的监督检查工作。

Objective To analyze the quality control test results of medical digital radiography(DR)equipment in Liaoning Province in 2021 to 2022 and understand the quality status of DR equipment to provide a reference for the hospitals to strengthen the quality management of DR equipment.Methods Using the convenient sampling method,75 medical DR equipment in use in 59 hospitals in Liaoning Province from 2021 to 2022 were selected as the research objects.The relevant equipment was used in accordance with the WS76—2020 Specification for Testing of Quality Control in Medical X-ray Diagnostic Equipment to test the general and special items of DR equipment from different manufacturers,observe whether the DR equipment has automatic exposure control(AEC)function and damage,and whether the equipment can obtain preprocessed images and pixel values.An independent sample t-test was used to compare the detection indexes of general and special items on different brands of equipment.The Kruskal-Wallis H test was utilized to compare the detection indexes among different brands of equipment.Results Among the 75 DR equipment,Siemens AG,Germany,accounted for 11%(8/75),Shanghai United Imaging Healthcare Co.,Ltd.accounted for 38%(29/75),Beijing Wandong Medical Technology Co.,Ltd.accounted for 13%(10/75),Neusoft Medical Systems Co.,Ltd.,Shenyang,accounted for 7%(5/75),and other companies accounted for 31%(23/75).The qualification rate of tube voltage indication and four side deviations between the light and irradiation fields detected by DR general testing projects in other companies is 96%(22/23).A total of 55%(41/75)of the equipment failed to detect AEC repeatability,AEC response,and consistency between AEC ionization chambers.In specialized testing projects,the qualification rate of ranging error in other companies is 88%(15/17)and that of other testing items is 100%.Meanwhile,51%(38/75)of equipment cannot detect detector dose indication,signal transmission characteristics,and response uniformity.A total of 15%(11/75)of the tested equipment has no measuring tools,resulting in measurement errors that cannot be calculated.A total of 40%(30/75)of the equipment have high and low contrast resolutions based on the survey results as the baseline value.Except for the undetected equipment,the remaining equipment accounted for 26%(10/38)of the baseline values for detector dose indication based on the survey results.In the special test items,the qualified rate of distance measuring error in other companies was 88%(15/17)and that of other test items was 100%.No significant difference was observed between the general and special test indexes among brands of equipment(H=0.34-9.38,all P>0.05).Conclusions The results suggested that the hospital should entrust qualified units to test the status of DR equipment annually to debug the equipment in time and ensure the accuracy of DR.At the same time,some DR equipment in hospitals lack detection functions and testing projects.The health administrative supervision department should provide standards for DR equipment testing in hospitals as soon as possible,and strengthen the supervision and inspection of DR equipment quality control.