Jones N F, Palarm T W, Negus I S
Directorate of Clinical Imaging, Royal Cornwall Hospitals NHS Trust (Treliske), Truro, Cornwall TR1 3LJ, UK.
Br J Radiol. 2001 Oct;74(886):920-5. doi: 10.1259/bjr.74.886.740920.
Radiographs of the chest and the abdomen are the most commonly requested diagnostic X-ray examinations undertaken in neonatal intensive care units. Frequently, for a single child, both radiographs are requested simultaneously. These images can be obtained either as two separate exposures (one of the chest and one of the abdomen), or as a single exposure to include both anatomical regions on one film. This study compared the effective dose imparted as a result of each technique. A neonatal anthropomorphic phantom was designed and constructed, and each radiographic technique was simulated. Entrance surface dose (ESD) and dose-area product (DAP) were measured and estimates of effective dose were made from the DAP values. The mean effective dose for the separate exposure technique was estimated to be 37.3 microSv compared with 35.5 microSv for the combined exposure technique. However, observed variations in field size gave rise to uncertainties in DAP and thus the effective doses estimated from it. Hence, no significant difference in effective dose was observed between the radiographic techniques. The observed coefficient of variation in field size (16% for a 2.5 kg neonate) demonstrates that good standards of radiographic practice are more important than choice of technique.
胸部和腹部X光片是新生儿重症监护病房最常要求进行的诊断性X光检查。通常,对于单个患儿,会同时要求拍摄这两张X光片。这些图像既可以通过两次单独曝光获得(一张胸部片和一张腹部片),也可以通过一次曝光在一张胶片上同时包含两个解剖区域。本研究比较了每种技术所产生的有效剂量。设计并制作了一个新生儿仿真体模,并模拟了每种X光摄影技术。测量了体表入射剂量(ESD)和剂量面积乘积(DAP),并根据DAP值估算有效剂量。单独曝光技术的平均有效剂量估计为37.3微希沃特,而联合曝光技术为35.5微希沃特。然而,观察到的视野大小变化导致DAP存在不确定性,进而导致由此估算的有效剂量也存在不确定性。因此,两种X光摄影技术在有效剂量方面未观察到显著差异。观察到的视野大小变异系数(2.5千克新生儿为16%)表明,良好的X光摄影操作规范比技术选择更为重要。