Pediatric computed tomography practice in Japanese university hospitals from 2008-2010: did it differ from German practice?
Pediatric computed tomography practice in Japanese university hospitals from 2008-2010: did it differ from German practice?
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DOI：
10.1093/jrr/rrw074
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发表时间：
2017-01
影响因子：
2
通讯作者：
Kudo T
中科院分区：
文献类型：
--
作者：
Yoshida K;Krille L;Dreger S;Hoenig L;Merzenich H;Yasui K;Kumagai A;Ohtsuru A;Uetani M;Mildenberger P;Takamura N;Yamashita S;Zeeb H;Kudo T
计算机断层扫描（CT）是现代医学中的重要工具，经常用于诊断各种疾病，特别是在工业国家，如日本和德国。然而，在CT成像期间传递的电离辐射剂量明显高于常规X射线检查期间。为了评估儿科CT实践模式，分析了三个大学医院数据库（两个在日本，一个在德国）的数据。提取了2008年至2010年期间接受CT检查的0至14岁患者的分析数据。为了评估CT实践，开发了一种CT适应症的跨学科分类方案，其中包括最常见的检查类型和放射敏感组织。CT检查的频率根据性别、检查时的年龄和适应症确定。共对2955名儿童进行了5182次CT检查。总的来说，日本大学医院的CT检查频率与德国医院没有显著差异。然而，在接受CT检查的患者的年龄分布（日本<5岁的患者比例显著高于德国）和CT适应症方面存在差异。三家医院在儿科医疗保健中使用CT方面存在实质性的实践差异。这项研究的结果指出，需要采取临床指南等方法，以减少日本卫生系统中不必要的医疗辐射照射，特别是腹部和头部CT。
Computed tomography (CT) is an essential tool in modern medicine and is frequently used to diagnose a wide range of conditions, particularly in industrial countries, such as Japan and Germany. However, markedly higher doses of ionizing radiation are delivered during CT imaging than during conventional X-ray examinations. To assess pediatric CT practice patterns, data from three university hospital databases (two in Japan and one in Germany) were analyzed. Anonymized data for patients aged 0 to 14 years who had undergone CT examinations between 2008 and 2010 were extracted. To assess CT practice, an interdisciplinary classification scheme for CT indications, which incorporated the most common examination types and radiosensitive tissues, was developed. The frequency of CT examinations was determined according to sex, age at examination, and indications. A total of 5182 CT examinations were performed in 2955 children. Overall, the frequency of CT examinations at the Japanese university hospitals did not differ significantly from that at the German hospital. However, differences were detected in the age distribution of the patients who underwent CT examinations (the proportion of patients <5 years of age was significantly higher in Japan than in Germany) and in the indications for CT. Substantial practice differences regarding the use of CT in pediatric health care were detected between the three hospitals. The results of this study point towards a need for approaches such as clinical guidelines to reduce unwarranted medical radiation exposures, particularly abdominal and head CT, in the Japanese health system.