CAJ | 학술논문

目的：应用医学数字成像和通信（ DICOM ）标准定义的辐射剂量结构化报告（ RDSR），实现CT检查的辐射剂量统计分析。方法利用自行设计的软件，通过检索影像归档和通信系统（ PACS），获取1230份CT检查的RDSR文件。将相关信息提取后，结合扫描部位建立患者剂量数据库。根据年龄将患者分为成年组（10岁以上）及儿童组（0～1岁，1～5岁，5～10岁），分别统计各扫描部位的平均容积CT剂量指数（ CTDIvol ）、剂量长度乘积（ DLP），估算有效剂量（ E）；并计算75％分位DLP值，与诊断学参考水平（ DRL）相比较。结果成年患者组，CTDIvol与DLP值呈中度正相关（r＝0?41），上腹部增强扫描的E最高，其75％分位DLP值超过DRL60％；儿童5～10岁组的CTDIvol高于0～1岁与1～5岁组（t＝2?42、2?04，P＜0?05）， DLP值与年龄呈低度正相关（r＝0?16），E与年龄呈中度负相关（r＝-0?48）。结论应用RDSR获得患者辐射剂量是一种简单、高效的方法。随着新设备的普及与区域化医疗平台的应用，RDSR将成为剂量学水平调查及个人剂量记录的主要工具。
목적：응용의학수자성상화통신（ DICOM ）표준정의적복사제량결구화보고（ RDSR），실현CT검사적복사제량통계분석。방법이용자행설계적연건，통과검색영상귀당화통신계통（ PACS），획취1230빈CT검사적RDSR문건。장상관신식제취후，결합소묘부위건립환자제량수거고。근거년령장환자분위성년조（10세이상）급인동조（0～1세，1～5세，5～10세），분별통계각소묘부위적평균용적CT제량지수（ CTDIvol ）、제량장도승적（ DLP），고산유효제량（ E）；병계산75％분위DLP치，여진단학삼고수평（ DRL）상비교。결과성년환자조，CTDIvol여DLP치정중도정상관（r＝0?41），상복부증강소묘적E최고，기75％분위DLP치초과DRL60％；인동5～10세조적CTDIvol고우0～1세여1～5세조（t＝2?42、2?04，P＜0?05）， DLP치여년령정저도정상관（r＝0?16），E여년령정중도부상관（r＝-0?48）。결론응용RDSR획득환자복사제량시일충간단、고효적방법。수착신설비적보급여구역화의료평태적응용，RDSR장성위제량학수평조사급개인제량기록적주요공구。
Objective To analyse the CT radiation dose statistically using the standardized radiation-dose-structured report (RDSR) of digital imaging and communications in medicine (DICOM). Methods Using the self-designed software, 1230 RDSR files about CT examination were obtained searching on the picture archiving and communication system ( PACS ) . The patient dose database was established by combination of the extracted relevant information with the scanned sites. The patients were divided into adult group (over 10 years) and child groups (0-1 year, 1-5 years, 5-10 years) according to the age. The average volume CT dose index ( CTDIvol ) and dose length product ( DLP) of all scans were recorded respectively, and then the effective dose ( E) was estimated. The DLP value at 75% quantile was calculated and compared with the diagnostic reference level ( DRL) . Results In adult group, CTDIvol and DLP values were moderately and positively correlated ( r=0?41 ) , the highest E was observed in upper abdominal enhanced scan, and the DLP value at 75% quantile was 60% higher than DRL. In child group, their CTDIvol in group of 5-10 years was greater than that in groups of 0-1 and 1-5 years ( t=2?42, 2?04, P<0?05);the DLP value was slightly and positively correlated with the age (r=0?16), while E was moderately and negatively correlated with the age ( r = -0?48 ) . Conclusions It is a simple and efficient method to use RDSR to obtain the radiation doses of patients. With the popularization of the new equipment and the application of regionalized medical platform, RDSR would become the main tool for the dosimetric level surveying and individual dose recording.