新型国产16排移动CT在神经重症监护中的应用时效性分析

doi:10.3877/cma.j.issn.2095-123X.2026.04.005

目的

分析新型国产16排移动CT在神经外科重症监护病房（ICU）中的时效性、安全性。

方法

收集四川省人民医院神经外科ICU自2023年1月至2024年10月住院患者的头颅CT检查资料，患者依据病情临床检查需要（如病情变化、常规复查）进行单次或多次CT头部扫描。按设备类型将历次检查数据分为移动CT组与固定大型CT组，对比2组CT的扫描流程、检查耗时、不良事件发生情况，并计算移动CT替代率。

结果

共纳入2274例患者，扫描8661次，其中固定大型CT扫描5214次，移动CT扫描3447次，替代率39.8%（3447/8661）。移动CT组的流程步骤少于固定大型CT组；移动CT组检查耗时[7.4（6.0，9.2）min]短于固定大型CT组[18.3（16.6，21.1）min]，差异有统计学意义（P<0.05）；移动CT组未发生坠床、管道脱落、休克等严重不良事件。

结论

16排移动CT重塑重症头部影像检查场景，在ICU监护中具有明确时效性优势。

关键词: 神经重症, 16排移动CT, 头部扫描, 时效性

Objective

To evaluate the timeliness and safety of domestically produced 16-slice mobile CT systems in neurosurgical intensive care units (ICUs).

Methods

Head CT examination data were collected from hospitalized patients in the Neurosurgery ICU of Sichuan Provincial People's Hospital from January 2023 to October 2024. Patients underwent single or multiple head CT scans according to clinical indications (e.g., disease progression monitoring or routine follow-up). Examination data were categorized into mobile CT group and fixed large-scale CT group according to device type. Comparison was conducted regarding scanning procedures, examination duration, incidence of adverse events, and the substitution rate of mobile CT.

Results

A total of 2274 patients underwent 8661 scans, including 5214 fixed large-scale CT scans and 3447 mobile CT scans, yielding a substitution rate of 39.8% (3447/8661). The mobile CT group required fewer procedural steps than the fixed large-scale CT group; its examination duration [7.4 (6.0, 9.2) min] was significantly shorter than that of the fixed large-scale CT group [18.3 (16.6, 21.1) min] (P<0.05). No severe adverse events such as bed falls, catheter dislodgement, or shock occurred in the mobile CT group.

Conclusions

The 16-slice mobile CT system revolutionizes head imaging examinations in critical care settings, demonstrating significant timeliness advantages in ICU monitoring.

Key words: Neurocritical care, 16-slice mobile CT, Head CT scanning, Timeliness

图1 16排移动CT和固定式大型CT的检查流程

Fig.1 Examination protocols for 16-slice mobile CT and fixed large-scale CT scanners

图2 2组典型患者相同病情阶段的影像学资料对比A~D：移动CT组；E~H：固定大型CT组；A、E：动脉瘤开颅夹闭术后；B、F：脑积水脑室外引流术；C、G：脑梗死病程复查；D、H：轻型脑伤病程复查

Fig.2 Comparison of imaging data from two groups of typical patients at the same disease stage

[1]	Liu Y, Karonen JO, Vanninen RL, et al. Acute ischemic stroke: predictive value of 2D phase-contrast MR angiography—serial study with combined diffusion and perfusion MR imaging[J]. Radiology, 2004, 231(2): 517-527. DOI: 10.1148/radiol.2312030565.
[2]	Kumar A, Alvarado A, Shah K, et al. Necessity of repeat computed tomography imaging in isolated mild traumatic subarachnoid hemorrhage[J]. World Neurosurg, 2018, 113: 399-403. DOI: 10.1016/j.wneu.2018.02.010.
[3]	钟浩,李嘉华,王玉召,等. CT检查对高血压性脑出血的诊断及临床预后评估价值分析[J].中国CT和MRI杂志, 2021, 19(7): 3. DOI: 10.3969/j.issn.1672-5131.2021.07.006.
[4]	Le Roux P, Menon DK, Citerio G, et al. Consensus summary statement of the international multidisciplinary consensus conference on multimodality monitoring in neurocritical care: a statement for healthcare professionals from the neurocritical care society and the European society of intensive care medicine[J]. Intensive Care Med, 2014, 40(9): 1189-1209. DOI: 10.1007/s00134-014-3369-6.
[5]	Rumboldt Z, Huda W, All JW. Review of portable CT with assessment of a dedicated head CT scanner[J]. AJNR Am J Neuroradiol, 2009, 30(9): 1630-1636. DOI: 10.3174/ajnr.A1603.
[6]	Tarnow-Mordi WO, Hau C, Warden A, et al. Hospital mortality in relation to staff workload: a 4-year study in an adult intensive-care unit[J]. Lancet, 2000, 356(9225): 185-189. DOI: 10.1016/s0140-6736(00)02478-8.
[7]	Masaryk T, Kolonick R, Painter T, et al. The economic and clinical benefits of portable head/neck CT imaging in the intensive care unit[J]. Radiol Manage, 2008, 30(2): 50-54.
[8]	蒋崇贵,陈隆益,曾义,等.新型国产16排移动CT和常规CT在神经重症监护室临床应用的时效性比较[J].中华神经创伤外科电子杂志, 2019, 5(6): 341-344. DOI: 10.3877/cma.j.issn.2095-9141.2019.06.005.
[9]	Gunnarsson T, Theodorsson A, Karlsson P, et al. Mobile computerized tomography scanning in the neurosurgery intensive care unit: increase in patient safety and reduction of staff workload[J]. J Neurosurg, 2000, 93(3): 432-436. DOI: 10.3171/jns.2000.93.3.0432.
[10]	Swanson EW, Mascitelli J, Stiefel M, et al. Patient transport and brain oxygen in comatose patients[J]. Neurosurgery, 2010, 66(5): 925-931; discussion 931-932. DOI: 10.1227/01.NEU.0000368543.59446.A4.
[11]	张志强,张远晨露,蔡金辉,等. 16排及8排移动CT多中心临床应用对比分析[J].中华神经创伤外科电子杂志, 2020, 6(6): 344-349. DOI: 10.3877/cma.j.issn.2095-9141.2020.06.005.
[12]	张志强,张强,魏群,等.移动式床旁CT颅脑扫描临床应用分析[J].中华神经创伤外科电子杂志, 2015, 1(2): 21-23. DOI: 10.3877/cma.j.issn.2095-9141.2015.02.007.
[13]	郑全乐,陈文锦,吴国华,等.重症监护患者床旁移动CT与常规CT头部扫描结果对比分析[J].中华脑科疾病与康复杂志(电子版), 2021, 11(5): 300-304. DOI: 10.3877/cma.j.issn.2095-123X.2021.05.009.
[14]	张志强,刘丽娟,张强,等.移动CT和常规CT检查对颅脑损伤后脑继发性损害及治疗效果的影响[J].中华神经医学杂志, 2016, 15(11): 1159-1163. DOI: 10.3760/cma.j.issn.1671-8925.2016.11.014.
[15]	张金戈,彭婉琳,李真林,等.移动CT头部扫描辐射剂量场的空间分布[J].中华放射医学与防护杂志, 2017, 37(4): 302-305. DOI: 10.3760/cma.j.issn.0254-5098.2017.04.014.
[16]	Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American heart association/American stroke association[J]. Stroke, 2019, 50(12): e344-e418. DOI: 10.1161/str.0000000000000211.
[17]	Stevens GC, Rowles NP, Foy RT, et al. The use of mobile computed tomography in intensive care: regulatory compliance and radiation protection[J]. J Radiol Prot, 2009, 29(4): 483-490. DOI: 10.1088/0952-4746/29/4/002.

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Temporal efficiency analysis of a novel domestic 16-slice mobile CT in neurocritical care

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Temporal efficiency analysis of a novel domestic 16-slice mobile CT in neurocritical care