Silverman S G, Tuncali K, Adams D F, Nawfel R D, Zou K H, Judy P F
Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Radiology. 1999 Sep;212(3):673-81. doi: 10.1148/radiology.212.3.r99se36673.
To evaluate the benefits of computed tomographic (CT) fluoroscopy-guided interventions and assess radiation exposures incurred with CT fluoroscopy.
A 6-month period of use of CT fluoroscopy to guide abdominal biopsy procedures and catheter drainage was analyzed. Efficacy measures and needle placement and procedure room times were compared with those of the preceding 6 months during which conventional CT was used. CT fluoroscopic times and estimated radiation exposures were compared for two CT fluoroscopic methods.
The sensitivity and negative predictive values for biopsy procedures and the success rate for needle aspiration or catheter drainages for CT fluoroscopy--98%, 86%, and 100%, respectively--were not significantly different from those for conventional CT--95%, 80%, and 97%, respectively. Room time was not reduced significantly, but mean needle placement time for CT fluoroscopy (29 minutes; n = 95) was significantly lower than that for conventional CT (36 minutes; n = 93; P < .005). The mean patient dose index was 74 cGy. Limiting CT fluoroscopy to scanning the needle tip rather than scanning the entire needle pass significantly reduced the dose to the patient and the operator.
Although CT fluoroscopy is a useful targeting technique, significant radiation exposures may result. Therefore, radiologists need to be aware of different methods of CT fluoroscopic guidance and the factors that contribute to radiation exposure.
评估计算机断层扫描(CT)透视引导介入治疗的益处,并评估CT透视时的辐射暴露情况。
分析了为期6个月使用CT透视引导腹部活检操作和导管引流的情况。将疗效指标、穿刺针放置情况和操作室时间与前6个月使用传统CT时的情况进行比较。比较了两种CT透视方法的CT透视时间和估计的辐射暴露量。
活检操作的敏感度和阴性预测值以及CT透视针吸活检或导管引流的成功率分别为98%丶86%和100%,与传统CT的相应数值(分别为95%丶80%和97%)相比,差异无统计学意义。操作室时间没有显著缩短,但CT透视的平均穿刺针放置时间(29分钟;n = 95)显著低于传统CT(36分钟;n = 93;P <.₀₀₅)。患者剂量指数平均值为74 cGy。将CT透视限制于扫描针尖而非扫描整个穿刺针行程,可显著降低患者和操作者所受的剂量。
尽管CT透视是一种有用的靶向技术,但可能导致显著的辐射暴露。因此,放射科医生需要了解CT透视引导的不同方法以及导致辐射暴露的因素。