某市1511例成年CT受检者辐射剂量和部分影响因素的调查研究  

A survey study on radiation dose and its influencing factors of 1 511 adult CT subjects in a city

作　　者：刘双[1] 邵小翠[1] 白金剑 沈晶[2] 宋冬冬[2] 张兴晖[1] LIU Shuang;SHAO Xiaocui;BAI Jinjian;SHEN Jing;SONG Dongdong;ZHANG Xinghui(Department of Occupational Radiation Health,Dalian Disease Control and Prevention Center,Liaoning 116033,China)

机构地区：[1]大连市疾病预防控制中心职业放射卫生科,辽宁116033 [2]大连大学附属中山医院放射科

出　　处：《工业卫生与职业病》2025年第1期36-40,共5页Industrial Health and Occupational Diseases

基　　金：大连市疾病预防控制中心预防医学科技攻关计划项目(DLCD C007)。

摘　　要：目的调查大连市部分成年CT受检者头部、胸部、腹部的扫描参数和辐射剂量,分析影响因素并提出改进措施。方法采集大连市4家医院1511例成年CT受检者的扫描参数和辐射剂量,通过剂量转换系数估算有效剂量。分析不同扫描参数、年龄组、不同医疗机构的辐射剂量差异性以及影响因素。结果18~<40和40~<70岁两个年龄组头部和胸部的辐射剂量长度乘积(dose length product,DLP)不同,分别为845、872 mGy·cm和416、446 mGy·cm,差异有统计学意义(χ^(2)=-3.65、-2.67,P<0.01)。4家医院头部、胸部和腹部的CT扫描参数均不同,差异均有统计学意义(P<0.01),头部DLP的P75位数分别为870、885、888、785 mGy.cm,胸部DLP的P75位数分别为461、501、356、471 mGy·cm,腹部DLP的P75位数分别为654、686、609、630 mGy·cm,差异均有统计学意义(χ^(2)=76.00、292.00、147.00,P<0.01),部分医院头部DLP高于诊断参考水平。结论依据年龄、BMI、扫描部位、疾病特点等个性化设置CT扫描参数有助于优化辐射剂量。医疗机构应提高辐射剂量管理水平,加强人员培训,定期进行辐射剂量核查,保证辐射剂量在合理范围内。有关部门应加强辐射剂量的监督管理,建立规范化的CT扫描和质控管理流程。Objective To investigate the scanning parameters and radiation doses of the head,chest and abdomen of some adult CT examinees in Dalian City,and to analyze the influencing factors, proposeing improvement measures.Methods Scanning parameters and radiation doses were collected from 1 511 adult CT subjects in 4 hospitals in Dalian City. The effective dose was estimated by the dose conversion factor. We analyzed the variability of radiation doses in different scanning parameters,age groups,different medical institutions and the influencing factors.Results The differences in radiation dose-length product(DLP)of head and chest was statistically significant between 18~ <40 and 40~ <70years age groups(χ^(2)=-3.65,-2.67,P<0.01),845,872 mGy·cm and 416,446 mGy·cm,respectively. The differences of CT scan parameters of the head,chest and abdomen were statistically significant(P<0.01)among the 4 hospitals.The 75th percentile of the head DLP were 870,885,888,785 mGy·cm,chest DLP were 461,501,356,471 mGy·cm,abdominal DLP were 654,686, 609,630 mGy·cm,all the differences above were all statistically significant(χ^(2)=76.00,292.00,147.00,P<0.01 ). Some hospitals have a higher DLP for the head than the diagnostic reference level.Conclusion Optimizing radiation dose requires personalized setting of CT scanning parameters based on age,BMI,scanning site,disease characteristics and so on. Medical institutions should improve radiation dose management, strengthen personnel trainingand conduct regular radiation dose verification to ensure the radiation dose is within a reasonable range.Relevant departments should strengthen the supervision and management of radiation dose,meanwhile standardized CT scanning and quality control management processes should be.

关 键 词：X射线计算机断层摄影 辐射剂量 容积CT剂量指数 辐射剂量长度乘积 

分 类 号：R144[医药卫生—公共卫生与预防医学]