OBJECTIVES:The objective was to determine the availability and quality of computed tomography (CT) and magnetic resonance imaging (MRI) equipment in U.S. emergency departments (EDs). The authors hypothesized that smaller, rural EDs have less availability and lower-quality equipment. METHODS:This was a random selection of 262 (5%) U.S. EDs from the 2005 National Emergency Department Inventories (NEDI)-USA (http://www.emnet-usa.org/). The authors telephoned radiology technicians about the presence of CT and MRI equipment, availability for ED imaging, and number of slices for the available CT scanners. The analysis was stratified by site characteristics. RESULTS:The authors collected data from 260 institutions (99% response). In this random sample of EDs, the median annual patient visit volume was 19,872 (interquartile range = 6,788 to 35,757), 28% (95% confidence interval [CI] = 22% to 33%) were rural, and 27% (95% CI = 21% to 32%) participated in the Critical Access Hospital program. CT scanners were present in 249 (96%) institutions, and of these, 235 (94%) had 24/7 access for ED patients. CT scanner resolution varied: 28% had 1-4 slice, 33% had 5-16 slice, and 39% had a more than 16 slice. On-site MRI was available for 171 (66%) institutions, and mobile MRI for 53 (20%). Smaller, rural, and critical access hospitals had lower CT and MRI availability and less access to higher-resolution CT scanners. CONCLUSIONS:Although access to CT imaging was high (>90%), CT resolution and access to MRI were variable. Based on observed differences, the availability and quality of imaging equipment may vary by ED size and location.

译文

目的:目的是确定美国急诊部门(ED)中计算机断层扫描(CT)和磁共振成像(MRI)设备的可用性和质量。作者假设,较小的农村ED的可用性较低,设备质量较低。
方法:这是从2005年美国国家紧急部门库存(NEDI)(美国http://www.emnet-usa.org/)中随机选择的262(5%)美国ED。作者打电话给放射技术人员,询问CT和MRI设备的存在,ED成像的可用性以及可用CT扫描仪的切片数量。通过现场特征对分析进行分层。
结果:作者从260个机构中收集了数据(99%的答复)。在此随机抽取的急诊科样本中,年患者就诊中位数为19,872(四分位间距= 6,788至35,757),农村地区为28%(95%置信区间[CI] = 22%至33%),27%(95%) CI = 21%到32%)参加了危重通道医院计划。 249个机构中有CT扫描仪(占96%),其中235例(94%)有ED患者使用24/7通道。 CT扫描仪的分辨率各不相同:28%的患者具有1-4层,33%的患者具有5-16层,39%的患者具有16层以上。 171所(66%)的机构可以使用现场MRI,53所(20%)的可以进行移动MRI。较小的,农村的和关键访问医院的CT和MRI可用性较低,而使用高分辨率CT扫描仪的机会较少。
结论:尽管获得CT成像的机会很高(> 90%),但CT分辨率和获得MRI的机会却是可变的。根据观察到的差异,成像设备的可用性和质量可能会因ED的大小和位置而异。

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