Binkert Christoph A, Verdun Francis R, Zanetti Marco, Pfirrmann Christian W, Hodler Juerg
Department of Radiology, University Hospital Balgrist, Zurich, Switzerland.
Radiology. 2003 Oct;229(1):153-8. doi: 10.1148/radiol.2291020314. Epub 2003 Aug 27.
To compare examination time with radiologist time and to measure radiation dose of computed tomographic (CT) fluoroscopy, conventional CT, and conventional fluoroscopy as guiding modalities for shoulder CT arthrography.
Glenohumeral injection of contrast material for CT arthrography was performed in 64 consecutive patients (mean age, 32 years; age range, 16-74 years) and was guided with CT fluoroscopy (n = 28), conventional CT (n = 14), or conventional fluoroscopy (n = 22). Room times (arthrography, room change, CT, and total examination times) and radiologist times (time the radiologist spent in the fluoroscopy or CT room) were measured. One-way analysis of variance and Bonferroni-Dunn posthoc tests were performed for comparison of mean times. Mean effective radiation dose was calculated for each method with examination data, phantom measurements, and standard software.
Mean total examination time was 28.0 minutes for CT fluoroscopy, 28.6 minutes for conventional CT, and 29.4 minutes for conventional fluoroscopy; mean radiologist time was 9.9 minutes, 10.5 minutes, and 9.0 minutes, respectively. These differences were not statistically significant. Mean effective radiation dose was 0.0015 mSv for conventional fluoroscopy (mean, nine sections), 0.22 mSv for CT fluoroscopy (120 kV; 50 mA; mean, 15 sections), and 0.96 mSv for conventional CT (140 kV; 240 mA; mean, six sections). Effective radiation dose can be reduced to 0.18 mSv for conventional CT by changing imaging parameters to 120 kV and 100 mA. Mean effective radiation dose of the diagnostic CT arthrographic examination (140 kV; 240 mA; mean, 25 sections) was 2.4 mSv.
CT fluoroscopy and conventional CT are valuable alternative modalities for glenohumeral CT arthrography, as examination and radiologist times are not significantly different. CT guidance requires a greater radiation dose than does conventional fluoroscopy, but with adequate parameters CT guidance constitutes approximately 8% of the radiation dose.
比较检查时间与放射科医生操作时间，并测量CT透视、传统CT及传统透视引导下肩关节CT关节造影的辐射剂量。
对64例连续患者（平均年龄32岁；年龄范围16 - 74岁）进行肩关节CT关节造影的关节内造影剂注射，分别采用CT透视引导（n = 28）、传统CT引导（n = 14）或传统透视引导（n = 22）。测量检查室时间（关节造影、更换检查室、CT检查及总检查时间）及放射科医生操作时间（放射科医生在透视或CT检查室花费的时间）。采用单因素方差分析及Bonferroni - Dunn事后检验比较平均时间。利用检查数据、模型测量及标准软件计算每种方法的平均有效辐射剂量。
CT透视引导下平均总检查时间为28.0分钟，传统CT引导下为28.6分钟，传统透视引导下为29.4分钟；放射科医生平均操作时间分别为9.9分钟、10.5分钟和9.0分钟。这些差异无统计学意义。传统透视引导下（平均9层扫描）平均有效辐射剂量为0.0015 mSv，CT透视引导下（120 kV；50 mA；平均15层扫描）为0.22 mSv，传统CT引导下（140 kV；240 mA；平均6层扫描）为0.96 mSv。将传统CT成像参数改为120 kV和100 mA时，有效辐射剂量可降至0.18 mSv。诊断性CT关节造影检查（140 kV；240 mA；平均25层扫描）的平均有效辐射剂量为2.4 mSv。
CT透视和传统CT是肩关节CT关节造影的有价值的替代方式，因为检查时间和放射科医生操作时间无显著差异。CT引导所需辐射剂量高于传统透视，但采用适当参数时，CT引导的辐射剂量约占总辐射剂量的8%。
