Simpson Andrew K, Whang Peter G, Jonisch Ari, Haims Andrew, Grauer Jonathan N
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06520-8071, USA.
J Spinal Disord Tech. 2008 Aug;21(6):409-12. doi: 10.1097/BSD.0b013e3181568656.
Cross-sectional study.
To calculate the effective radiation doses of routine anteroposterior (AP) and lateral radiographs of the cervical and lumbar spines.
Although plain radiographs are generally used as the initial imaging modality for the evaluation of patients with spinal complaints, the radiation that patients receive during these studies has not been well quantified. The effective radiation dose represents a functional measure of exposure that takes into account the amount of radiation delivered and the radiosensitivity of the exposed organs. Consequently, the effective dose is important to consider from a radiation safety perspective.
The imaging practices of our radiology department were reviewed and the effective radiation doses for AP and lateral radiographs of the cervical and lumbar spines were calculated using the following variables: emitted radiation dose, source-to-object distance [SOD], film area, and patient tissue dimensions. Values were obtained from both direct measurements and an examination of the established protocols employed at our institution.
The effective doses for AP and lateral cervical radiographs were 0.12 and 0.02 mSv, respectively, whereas the corresponding values for AP and lateral lumbar films were much larger (2.20 and 1.50 mSv, respectively). For comparative purposes, a typical chest x-ray results in a radiation dose between 0.06 and 0.25 mSv.
In this investigation, cervical spine films gave rise to radiation doses that are similar to those of chest x-rays. However, lumbar spine radiographs generated effective radiation doses that were approximately an order of magnitude greater than these other studies. In both the cervical and lumbar regions, AP views resulted in significantly greater radiation exposure than corresponding lateral images. The effective radiation doses reported here may prove to be valuable for assessing the relative risks and benefits of spine radiographs to establish appropriate guidelines for their use.
横断面研究。
计算颈椎和腰椎常规前后位（AP）及侧位X线片的有效辐射剂量。
尽管普通X线片通常被用作评估脊柱疾病患者的初始影像学检查方法，但患者在这些检查过程中所接受的辐射尚未得到很好的量化。有效辐射剂量是一种考虑了所传递辐射量和受照器官放射敏感性的功能性暴露度量。因此，从辐射安全角度考虑，有效剂量很重要。
回顾了我们放射科的成像操作，并使用以下变量计算颈椎和腰椎AP及侧位X线片的有效辐射剂量：发射辐射剂量、源到物体距离[SOD]、胶片面积和患者组织尺寸。数值通过直接测量以及对我们机构所采用的既定方案的检查获得。
颈椎AP和侧位X线片的有效剂量分别为0.12和0.02 mSv，而腰椎AP和侧位片的相应数值要大得多（分别为2.20和1.50 mSv）。为作比较，典型的胸部X线片产生的辐射剂量在0.06至0.25 mSv之间。
在本研究中，颈椎X线片产生的辐射剂量与胸部X线片相似。然而，腰椎X线片产生的有效辐射剂量比其他这些研究大约高一个数量级。在颈椎和腰椎区域，AP位片导致的辐射暴露均显著高于相应的侧位片。这里报告的有效辐射剂量可能对评估脊柱X线片的相对风险和益处有价值，从而为其使用制定适当的指南。
