通过摩洛哥成人头部计算机断层扫描临床指征建立首个国家诊断参考水平:一项基线研究。

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Youssef Madkouri, Hamza Sekkat, Abdellah Khallouqi
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引用次数: 0

摘要

目的:计算机断层扫描(CT)在摩洛哥各地急诊护理中的广泛和日益增长的使用引起了对辐射安全的严重关切,特别是在没有国家诊断参考水平(drl)的情况下。如果没有针对特定临床适应症的drl,就很难确定不合理的剂量变化并确保安全操作。该研究旨在建立摩洛哥首个基于临床适应症的成人头部CT检查国家drl,促进辐射剂量优化并与国际安全标准保持一致。方法:对摩洛哥20家医院1,299例成人头部CT检查进行回顾性多中心分析。临床指征分为7组:脑卒中、急性神经系统症状、造影后成像(肿瘤/脓肿)、CT血管造影、肿瘤规划、窦骨和颞骨成像。提取关键参数和剂量指标,并利用体积CT剂量指数(CTDIvol)的第75百分位(第三四分位数)和每个适应证的剂量-长度积(DLP)分布来确定drl。结果:不同治疗方案的DLP差异显著(最高:肿瘤[1794.8±128.8 mGy·cm];最低:颞骨[398.4±20.3 mGy·cm])。出现了地理差异,Agadir(2211毫戈瑞·厘米)和Al Hoceima(2204毫戈瑞·厘米)的剂量最高,而Dakhla(790毫戈瑞·厘米)的剂量最高。卒中dlp(880.7±70.5 mGy·cm)低于一些国际基准,反映了摩洛哥实践的方案和地区差异。结论:本研究建立了第一套针对成人头部CT的全国性、特定适应症的drl。这些基准为剂量优化提供了基础工具,帮助放射科评估当前做法,减少不必要的照射并促进对国际准则的遵守。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Establishment of the first National diagnostic reference levels by clinical indication for adult head computed tomography in morocco: A baseline study.

Purpose: The widespread and growing use of computed tomography (CT) in emergency care across Morocco has raised critical concerns about radiation safety, particularly in the absence of national Diagnostic Reference Levels (DRLs). Without DRLs tailored to specific clinical indications, it becomes difficult to identify unjustified dose variations and ensure safe practices. This study aims to establish Morocco's first national, clinical indication-based DRLs for adult head CT examinations, promoting radiation dose optimization and alignment with international safety standards.

Methods: A retrospective multicenter analysis was performed on 1,299 adult head CT examinations across 20 Moroccan hospitals. Clinical indications were categorized into seven groups: stroke, acute neurological symptoms, post-contrast imaging (tumor/abscess), CT angiography, oncology planning, sinus and temporal bone imaging. Key parameters and dose metrics were extracted and the 75th percentile (third quartile) of volumetric CT dose index (CTDIvol) and dose-length product (DLP) distribution per indication was used to propose DRLs.

Results: DLP varied significantly across protocols (highest: oncology [1794.8 ± 128.8 mGy·cm]; lowest: temporal bone [398.4 ± 20.3 mGy·cm]). Geographic disparities emerged, with Agadir (2211 mGy·cm) and Al Hoceima (2204 mGy·cm) showing the highest doses versus Dakhla (790 mGy·cm). Stroke DLPs (880.7 ± 70.5 mGy·cm) were lower than some international benchmarks, reflecting protocol and regional differences in Moroccan practice.

Conclusion: The study establishes the first set of national, indication-specific DRLs for adult head CT. These benchmarks provide a foundational tool for dose optimization, helping radiology departments evaluate current practices, reduce unnecessary exposure and promote compliance with international guidelines.

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来源期刊
Emergency Radiology
Emergency Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
4.60
自引率
4.50%
发文量
98
期刊介绍: To advance and improve the radiologic aspects of emergency careTo establish Emergency Radiology as an area of special interest in the field of diagnostic imagingTo improve methods of education in Emergency RadiologyTo provide, through formal meetings, a mechanism for presentation of scientific papers on various aspects of Emergency Radiology and continuing educationTo promote research in Emergency Radiology by clinical and basic science investigators, including residents and other traineesTo act as the resource body on Emergency Radiology for those interested in emergency patient care Members of the American Society of Emergency Radiology (ASER) receive the Emergency Radiology journal as a benefit of membership!
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