儿童头颅CT检查不同辐射剂量衡量指标差异性比较及相关性分析OACSTPCD
Comparison and correlation analysis of different radiation dose indicators in children's head CT examination
目的:比较容积CT剂量指数(volume CT dose index,CTDIVOL)及基于水当量直径的体型特异性剂量估计值(size-specific dose estimate based on water equivalent diameter,SSDEWED)在衡量儿童头颅 CT 辐射剂量中的差异性,并分析CTDIVOL、SSDEWED与曝光量、水当量直径(water equivalent diameter,WED)的相关性,以为临床检查中儿童头颅CT辐射剂量衡量提供参考.方法:回顾性分析2021年1-12月于某院进行头颅CT检查的1 297例患儿的临床资料,根据年龄将患儿分为≤1个月组、＞1个月～4岁组、＞4～10岁组、＞10～15岁组.记录患儿的曝光量、年龄、CTDIVOL、剂量长度乘积,并计算WED、转换因子及SSDEWED.比较CTDIVOL与SSDEWED的差异;建立CTDIVOL、SSDEWED与曝光量、WED的回归模型,并采用Pearson分析CTDIVOL、SSDEWED与曝光量、WED之间的相关性;对比国内诊断参考水平(diagnostic reference level,DRL)、欧盟 DRL 及本医疗机构诊断参考水平(local diagnostic reference level,LDRL)的差异.采用SPSS 25.0统计学软件进行分析.结果:患儿头颅CT的CTDIVOL为(9.22±1.63)mGy,SSDEWED为(8.14±0.84)mGy,CTDIVOL较SSDEWED高13.27％,差异有统计学意义(t=47.66,P＜0.001).CTDIVOL、SSDEWED与曝光量、WED均呈正相关关系(P＜0.001);CTDIVOL、SSDEWED与曝光量、WED回归模型拟合性较强(R2为0.58～0.99).与国内DRL及欧盟DRL比较,LDRL均处于较低水平.结论:在儿童头颅CT辐射剂量衡量中,相较于CTDIVOL,SSDE WED对辐射剂量的衡量更准确.同时定期对医疗机构的DRL值进行统计更新并优化检查参数,是减少辐射剂量的重要方式.
Objective To compare the differences between volume CT dose index(CTDIVOL)and size-specific dose estimate based on water equivalent diameter(SSDEWED)in measuring head CT radiation in children and analyze the correlations between CTDIVOL and SSDEWED based on water equivalent diameter with exposure dose and water equivalent diameter(WED),so as to provide references for the measurement of head CT radiation of children.Methods Totally 1 297 child patients undergoing cranial CT examination in some hospital from January to December 2021 were analyzed retrospectively,and were divided into four groups whose ages were not higher than one month,higher than one month to four years,higher than 4 years to 10 years and higher than 10 years to 15 years,respectively.The exposure dose,age,CTDIVOL and dose length product of the children were recorded,and the WED,conversion factor and SSDEWED were calculated.The differences between CTDIVOL and SSDEWED were compared;the regression models of CTDIVOL and SSDEWED with exposure dose and WED were established,and the correlations between them were explored with Pearson analysis;the differences were analyzed between the diagnostic reference level(DRL)in China,EU DRL and local DRL(LDRL).SPSS 25.0 was used for statistical analysis.Results The CTDIVOL of the children's cranial CT was(9.22±1.63)mGy,and SSDEWED was(8.14±0.84)mGy,and CTDIvoL was 13.27％higher than SSDEWED,with a statistically significant difference(t=47.66,P＜0.001).CTDIVOL and SSDEWED were both positively correlated with exposure dose and WED(P＜0.001);the CTDIVOL and SSDEWED regression models with exposure dose and WED fitted well with R2 being 0.58 to 0.99.LDRLs were at a lower level when compared with DRLs in EU and China.Conclusion SSDEWED behaves better than CTDIVOL when used for measuring head CT radiation in children.Regular statistical updating of DRL values in medical institutions and optimization of examination parameters are important ways to reduce radiation doses.[Chinese Medical Equipment Journal,2024,45(7):46-50]
张见;杨凤;张晓军
南京医科大学附属儿童医院放射科,南京 210008
基础医学
儿童头颅CTCTDIVOLSSDEWEDLDRLDRL辐射剂量
children cranial CTvolume CT dose indexsize-specific dose estimate based on water equivalent diameterlocal diagnostic reference leveldiagnostic reference levelradiation dose
《医疗卫生装备》 2024 (007)
46-50 / 5
江苏省政府留学基金项目(JS-2018-137)
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