Zammit-Maempel I, Chadwick C L, Willis S P
Departments of Radiology Freeman Hospital, Newcastle and Regional Medical Physics, Newcastle General Hospital, Newcastle upon Tyne, UK.
Br J Radiol. 2003 Jun;76(906):418-20. doi: 10.1259/bjr/82798696.
CT has become an established examination in the evaluation of the paranasal sinuses. Until recently this was achieved by the direct coronal technique on conventional and single slice helical scanners. With the advent of multislice technology, thin slice axial CT with excellent coronal and sagittal reconstructions is now the norm. We describe a study designed to evaluate the radiation dose to the lens of the eye and thyroid gland in the axial and coronal planes on a Siemens Volume Zoom quad slice scanner at 140 kV and effective mAs of 100 using 1 mm collimation. Thermoluminescent dosimeters were placed on the eyelid and thyroid gland of 29 patients scanned axially in the supine position and a further 28 patients scanned coronally in the prone position with gantry tilt. The results show mean doses of 35.1 mGy (lens) and 2.9 mGy (thyroid gland) in the coronal plane compared with 24.5 mGy (lens) and 1.4 mGy (thyroid gland) in the axial plane. Results obtained from a head phantom and from using the ImPACT CT dose calculator were comparable. The kV and mAs were then reduced to 120 and 40, respectively, and the axial study repeated using the head phantom and predicted doses using the ImPACT CT dose calculator. The low dose scanning technique revealed a lens dose of 9.2 mGy and thyroid dose of 0.4 mGy. The eye dose on a multislice scanner is still substantially less than the threshold dose of 0.5-2 Gy for detectable lens opacities. These results indicate that, in addition to the established perceived advantages of multislice axial sinus CT, i.e. patient comfort, no artefact from dental amalgam and reproducible true coronal images, should be included a decreased radiation dose to both the eye lens and thyroid gland compared with direct coronal scanning.
CT已成为评估鼻窦的常用检查方法。直到最近,这还是通过传统和单层螺旋扫描仪上的直接冠状位技术来实现的。随着多层技术的出现,具有出色冠状位和矢状位重建的薄层轴位CT现在已成为标准。我们描述了一项研究,旨在评估在西门子Volume Zoom四层螺旋扫描仪上,使用1毫米准直,在140 kV和有效mAs为100的条件下,轴位和冠状位平面上眼睛晶状体和甲状腺所接受的辐射剂量。将热释光剂量计放置在29例仰卧位进行轴位扫描的患者的眼睑和甲状腺上,以及另外28例俯卧位且机架倾斜进行冠状位扫描的患者的眼睑和甲状腺上。结果显示,冠状位平面上的平均剂量为35.1 mGy(晶状体)和2.9 mGy(甲状腺),而轴位平面上分别为24.5 mGy(晶状体)和1.4 mGy(甲状腺)。从头部模型以及使用ImPACT CT剂量计算器获得的结果具有可比性。然后将kV和mAs分别降至120和40,并使用头部模型重复进行轴位研究,并使用ImPACT CT剂量计算器预测剂量。低剂量扫描技术显示晶状体剂量为9.2 mGy,甲状腺剂量为0.4 mGy。多层螺旋扫描仪上的眼部剂量仍远低于可检测到晶状体混浊的阈值剂量0.5 - 2 Gy。这些结果表明,除了多层轴位鼻窦CT已有的公认优势,即患者舒适度高、无牙科汞合金伪影以及可重复的真实冠状位图像外,与直接冠状位扫描相比,还应包括对眼睛晶状体和甲状腺的辐射剂量降低。