在计算机断层扫描中估计病人剂量的标准的新方法的论证

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论证。在计算机断层扫描（CT）检查数量急剧增加的时候，改进监测病人剂量的方法越来越迫切，不要超过推荐水平。

目的是分析身体各部分CT的有效剂量（ED）对病人体重的依赖性，并计算体重70公斤和80公斤的病人的标准ED。

方法。我们分析了CT检查的协议——单相（SP）（209名患者）和多相（MP）（114名患者）。ED是根据身体各部分（头部、胸部、腹部和骨盆）的归一化系数计算的。对于每一种CT扫描仪和扫描的身体面积，使用线性ED函数与体重的关系来计算标准的ED值，标准的ED值是通过近似的数据，对于体重70公斤或80公斤的标准病人。

结果。在CT扫描中发现，ED的增加与病人体重成正比。计算了平均ED、中位ED、DRLs（mSv），并与SP和MP CT的标准ED值（mSv）进行了比较。在所有比较组中，如果标准是体重70公斤，这些指标略高于标准ED，如果标准是体重80公斤，这些指标接近标准ED。同时表现了，不仅可以使用按标准体重取样的病人的数据，而且可以通过近似法使用整个数据集来计算标准ED。按所研究的身体部分，这可以用于改进比较导则和使患者的CT辐射剂量标准化。

结论。该研究描述了一种评估和比较CT辐射剂量的方法，以两家医院和两台CT扫描仪为例，考虑到一个标准病人的体重。结果显示，不是平均ED、中位ED或75分位ED，而是计算和分析每个身体部分的标准ED，有助于更正确地比较不同医疗机构的辐射量，分析超过区域或国家的参考诊断水平（DRLs）的原因。随着最近CT检查数量的急剧增加，为了减少人口中癌症病理形式的长期后果，应该不超过CT中使用标准ED标准计算的DRLs。

作者简介

Elena I. Matkevich

State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency; I.V. Davydovsky City Clinical Hospital

Email: pencil_red@mail.ru
ORCID iD: 0000-0001-5917-7706
SPIN 代码: 5546-4830

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow; Moscow

Valentin Е. Sinitsyn

I.V. Davydovsky City Clinical Hospital; Lomonosov Moscow State University

Email: vsini@mail.ru
ORCID iD: 0000-0002-5649-2193
SPIN 代码: 8449-6590

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow; Moscow

Ivan V. Ivanov

Sechenov First Moscow State Medical University (Sechenov University); State Scientific-Research Test Institute of Military Medicine

编辑信件的主要联系方式.
Email: ivanov-iv@yandex.ru
ORCID iD: 0000-0001-7729-2724
SPIN 代码: 9888-2780

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow; Saint Petersburg

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2. 图1。在头部、胸部、腹部器官+盆腔内脏器官单期相计算机断层扫描中有效剂量对患者体重依赖性的回归分析结果。Y轴——有效剂量，mSv；X轴——患者体重，公斤。 符号：实线——回归图线，点线表示回归图线的置信区间，p=0.95，垂直于轴的实线——标准ED70公斤和标准ED80公斤（mSv），针对体重为70/80公斤的患者，虚线表示对应于该组患者平均体重的平均ED（mSv）。 ED——有效剂量；CT——计算机断层摄影。

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3. 图2。在头部、胸部、腹部器官+盆腔内脏器官多期相计算机断层扫描中有效剂量对患者体重依赖性的回归分析结果（点线表示置信区间，p=0.95）。Y轴——有效剂量，mSv；X轴——患者体重，公斤。 符号：实线——回归图线，点线表示回归图线的置信区间，p=0.95，垂直于轴的实线——标准ED70公斤和标准ED80公斤（mSv），针对体重为70/80公斤的患者，虚线表示对应于该组患者平均体重的平均ED（mSv）。 ED——有效剂量；CT——计算机断层摄影。

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