Tschammler A, Kenn W, Dinkel H P, Sandstede J, Keberle M, Tschammler S
Institut für Röntgendiagnostik der Universität Würzburg.
Rofo. 2005 Aug;177(8):1123-30. doi: 10.1055/s-2005-858323.
To search for individualized scan protocols that provide adequate diagnostic information with minimal radiation exposure for abdominal CT in adults.
Beginning with standard settings (120 kVp, 200 mA, 0.75 s, CTDI (w = 11.7 mGy)), which are in the lowest quartile of the actual German radiation dose survey, 119 adults were examined using a single-row detector helical CT with 8 mm collimation and a pitch of 1.5. The individualized scan protocol was defined by repeating the reference scan up to 3 times with different radiation doses following a predefined iteration scheme. The image qualities with standard dose and with individualized dose were assessed independently by 3 radiologists blinded to the exposure parameters. The individualized dose was correlated with the diameter of the patients.
The patient diameters varied from 16 to 35 cm and correlated with individualized radiation doses CTDI (w) from 6.4 to 17.6 mGy. We found an exponential correlation (y = 52.3 x e (0.05 x); r(2) = 0.48; p < 0.001) between required tube current (mA) and a. p. diameter (cm) in the epigastric region in adults.
Maintaining constant exposure parameters results in unnecessary radiation exposure in patients with a diameter of less than 27 cm measured in anterior-posterior direction in the epigastric area. The radiation exposure in adult abdominal CT can be reduced up to 45 % by individualized selection of the tube current without adversely affecting diagnostic performance.
寻找个体化扫描方案,以在为成人进行腹部CT检查时,用最小的辐射暴露提供足够的诊断信息。
从实际德国辐射剂量调查中处于最低四分位数的标准设置(120 kVp、200 mA、0.75 s、CTDI(w = 11.7 mGy))开始,使用准直为8 mm且螺距为1.5的单排探测器螺旋CT对119名成人进行检查。个体化扫描方案通过按照预定义的迭代方案,用不同辐射剂量重复参考扫描多达3次来定义。由3名对暴露参数不知情的放射科医生独立评估标准剂量和个体化剂量下的图像质量。个体化剂量与患者的直径相关。
患者直径从16 cm到35 cm不等,与个体化辐射剂量CTDI(w)从6.4 mGy到17.6 mGy相关。我们发现成人上腹部区域所需管电流(mA)与前后径(cm)之间存在指数相关性(y = 52.3 x e(0.05 x);r(2) = 0.48;p < 0.001)。
对于上腹部区域前后径小于27 cm的患者,保持恒定的暴露参数会导致不必要的辐射暴露。通过个体化选择管电流,成人腹部CT的辐射暴露可降低多达45%,且不会对诊断性能产生不利影响。