Muhogora Wilbroad E, Ahmed Nada A, Almosabihi Aziz, Alsuwaidi Jamila S, Beganovic Adnan, Ciraj-Bjelac Olivera, Kabuya Francois K, Krisanachinda Anchali, Milakovic Milomir, Mukwada Godfrey, Ramanandraibe Marie J, Rehani Madan M, Rouzitalab Jalil, Shandorf Cyril
Tanzania Atomic Energy Commission, Arusha, Tanzania.
AJR Am J Roentgenol. 2008 Jun;190(6):1453-61. doi: 10.2214/AJR.07.3039.
The purpose of this study was to survey image quality and the entrance surface air kerma for patients in radiographic examinations and to perform comparisons with diagnostic reference levels.
In this multinational prospective study, image quality and patient radiation doses were surveyed in 12 countries in Africa, Asia, and Eastern Europe, covering 45 hospitals. The rate of unsatisfactory images and image quality grade were noted, and causes for poor image quality were investigated. The entrance surface doses for adult patients were determined in terms of the entrance surface air kerma on the basis of X-ray tube output measurements and X-ray exposure parameters. Comparison of dose levels with diagnostic reference levels was performed.
The fraction of images rated as poor was as high as 53%. The image quality improved up to 16 percentage points in Africa, 13 in Asia, and 22 in Eastern Europe after implementation of a quality control (QC) program. Patient doses varied by a factor of up to 88, although the majority of doses were below diagnostic reference levels. The mean entrance surface air kerma values in mGy were 0.33 (chest, posteroanterior), 4.07 (lumbar spine, anteroposterior), 8.53 (lumbar spine, lateral), 3.64 (abdomen, anteroposterior), 3.68 (pelvis, anteroposterior), and 2.41 (skull, anteroposterior). Patient doses were found to be similar to doses in developed countries and patient dose reductions ranging from 1.4% to 85% were achieved.
Poor image quality constitutes a major source of unnecessary radiation to patients in developing countries. Comparison with other surveys indicates that patient dose levels in these countries are not higher than those in developed countries.
本研究旨在调查放射检查中患者的图像质量和体表空气比释动能，并与诊断参考水平进行比较。
在这项多国前瞻性研究中，对非洲、亚洲和东欧12个国家的45家医院的图像质量和患者辐射剂量进行了调查。记录不满意图像的比例和图像质量等级，并调查图像质量差的原因。根据X射线管输出测量值和X射线曝光参数，以体表空气比释动能来确定成年患者的体表剂量。将剂量水平与诊断参考水平进行比较。
被评为质量差的图像比例高达53%。实施质量控制（QC）计划后，非洲的图像质量提高了16个百分点，亚洲提高了13个百分点，东欧提高了22个百分点。患者剂量相差高达88倍，尽管大多数剂量低于诊断参考水平。以毫戈瑞为单位的平均体表空气比释动能值分别为：胸部后前位0.33、腰椎前后位4.07、腰椎侧位8.53、腹部前后位3.64、骨盆前后位3.68、颅骨前后位2.41。发现患者剂量与发达国家的剂量相似，并且实现了1.4%至85%的患者剂量降低。
图像质量差是发展中国家患者接受不必要辐射的主要来源。与其他调查相比表明，这些国家的患者剂量水平并不高于发达国家。
