Lucey Brian C, Varghese Jose C, Hochberg Aaron, Blake Michael A, Soto Jorge A
Department of Radiology, Division of Body Imaging, Boston University Medical Center, 88 E Newton St., Atrium 2, Boston, MA 02118, USA.
AJR Am J Roentgenol. 2007 May;188(5):1187-94. doi: 10.2214/AJR.06.0378.
The purpose of this study was to evaluate the feasibility of performing CT-guided interventional procedures with a very low radiation dose.
We performed 291 CT-guided interventional procedures using a low dose of radiation. The subjects were 165 men and 126 women 22-89 years old with a mean age of 65 years. CT fluoroscopy was not used. The procedures were 201 percutaneous biopsies and 90 percutaneous aspiration or drainage procedures. Before the procedure, images were obtained with standard mAs of 175-250 mAs. All subsequent CT was performed at a reduced mAs. Technical success of catheter placement and biopsy was calculated, and the results were compared with those of procedures performed over the previous 12 months with standard radiation doses. Patient weight, lesion size, and number of CT acquisitions needed to complete the procedure were recorded.
All but three aspiration or drainage procedures performed at 30 mAs were successful, for a success rate of 96.7%. The technical success rate of biopsy performed at 30 mAs was 93.5%. In the cases of 13 patients undergoing biopsy, the masses were not identified with low-dose technique, and these procedures were completed at a higher dose. Results were independent of patient weight and lesion size. The technical success rate was 98% for percutaneous drainage performed at a standard radiation dose in the 12 months before introduction of the low-dose technique. The technical success rate was 87.5% for biopsy performed at a standard radiation dose in the 12 months before introduction of the low-dose technique. The complication rate of the low-dose technique was comparable to that of the standard-dose technique.
Low-dose radiation technique using 30 mAs results in technical success for both catheter placement and percutaneous biopsy comparable to standard radiation dose.
本研究旨在评估采用极低辐射剂量进行CT引导介入操作的可行性。
我们使用低剂量辐射进行了291例CT引导介入操作。受试者为165名男性和126名女性，年龄在22至89岁之间，平均年龄65岁。未使用CT透视。操作包括201例经皮活检和90例经皮抽吸或引流操作。操作前，以175 - 250 mAs的标准管电流时间乘积获取图像。所有后续CT扫描均以降低的管电流时间乘积进行。计算导管置入和活检的技术成功率，并将结果与前12个月采用标准辐射剂量进行的操作结果进行比较。记录患者体重、病变大小以及完成操作所需的CT采集次数。
除3例在30 mAs下进行的抽吸或引流操作外，其余均成功，成功率为96.7%。在30 mAs下进行活检的技术成功率为93.5%。在13例接受活检的患者中，低剂量技术未能识别出肿块，这些操作以更高剂量完成。结果与患者体重和病变大小无关。在低剂量技术引入前的12个月中，标准辐射剂量下经皮引流的技术成功率为98%。在低剂量技术引入前的12个月中，标准辐射剂量下活检的技术成功率为87.5%。低剂量技术的并发症发生率与标准剂量技术相当。
采用30 mAs的低剂量辐射技术在导管置入和经皮活检方面的技术成功率与标准辐射剂量相当。
