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胸部多层螺旋计算机断层扫描期间女性乳房的辐射暴露以及铋乳房防护板降低乳房辐射剂量的有效性。

Female breast radiation exposure during thorax multidetector computed tomography and the effectiveness of bismuth breast shield to reduce breast radiation dose.

作者信息

Yilmaz Mehmet Halit, Albayram Sait, Yaşar Doğan, Ozer Harun, Adaletli Ibrahim, Selçuk Doğan, Akman Canan, Altuğ Ayça

机构信息

Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Turkey.

出版信息

J Comput Assist Tomogr. 2007 Jan-Feb;31(1):138-42. doi: 10.1097/01.rct.0000235070.50055.e6.

Abstract

OBJECTIVE

The purpose of our study was to determine the breast radiation dose when performing routine thoracic multidetector computed tomography (MDCT). We also evaluated dose reduction and the effect on image quality of using a bismuth breast shield when performing thoracic MDCT.

MATERIAL AND METHODS

The dose reduction achievable by shielding the adult (18 years or older) female breasts was studied in 50 women who underwent routine thoracic MDCT. All examinations were performed with a 16-MDCT scanner (Sensation Cardiac 16; Siemens Medical Solutions). To compare the shielded/unshielded breast dose, the examination was performed with (right breast) and without (left breast) breast shielding in all patients. With this technique, the superficial breast doses were calculated. To determine the average glandular breast radiation dose, we imaged an anthropomorphic dosimetric phantom into which calibrated dosimeters were placed to measure the dose to breast. The phantom was imaged using the same protocol. Radiation doses to the breasts with and without the breast shielding were measured and compared using the Student t test.

RESULTS

In the qualitative evaluation of the MDCT scans, all were considered to be of diagnostic quality. We did not see any differences in quality between the shielded and unshielded lung. The mean radiation doses to the breasts with the shield and to those without the shield were 8.6 +/- 2.33 versus 14.46 +/- 3.94 mGy, respectively. The breast shield enabled a 40.53% decrease in radiation dose to the breast. The difference between the dose received by the breasts with and that received by the breasts without bismuth shielding was significant, with a P value of less than 0.001.

CONCLUSIONS

Bismuth in-plane shielding for routine thoracic MDCT decreased radiation dose to the breast without qualitative changes in image quality. The other radiosensitive superficial organs (eg, testes and thyroid gland) specifically must be protected with shielding.

摘要

目的

我们研究的目的是确定进行常规胸部多排螺旋计算机断层扫描(MDCT)时的乳房辐射剂量。我们还评估了在进行胸部MDCT时使用铋制乳房防护屏的剂量降低情况及其对图像质量的影响。

材料与方法

对50名接受常规胸部MDCT检查的女性进行研究,以探讨屏蔽成年(18岁及以上)女性乳房可实现的剂量降低情况。所有检查均使用16排MDCT扫描仪(Sensation Cardiac 16;西门子医疗解决方案公司)进行。为比较屏蔽/未屏蔽乳房的剂量,所有患者均进行了有(右乳房)和无(左乳房)乳房防护屏的检查。采用该技术计算乳房表面剂量。为确定平均乳腺腺体辐射剂量,我们对一个放置了校准剂量计以测量乳房剂量的人体模型进行成像。该模型使用相同的方案进行成像。使用学生t检验测量并比较有和无乳房防护屏时乳房的辐射剂量。

结果

在MDCT扫描的定性评估中,所有图像均被认为具有诊断质量。我们未发现屏蔽和未屏蔽肺部的图像质量有任何差异。有防护屏和无防护屏时乳房的平均辐射剂量分别为8.6±2.33 mGy和14.46±3.94 mGy。乳房防护屏使乳房辐射剂量降低了40.53%。有铋防护屏和无铋防护屏时乳房所接受剂量之间的差异具有统计学意义,P值小于0.001。

结论

常规胸部MDCT的平面内铋屏蔽可降低乳房辐射剂量,且图像质量无定性变化。其他对辐射敏感的浅表器官(如睾丸和甲状腺)必须特别使用防护屏进行保护。

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