Tappero C, Barbero S, Costantino S, Bergui M, Ropolo R, Bradac G, Gandini G
ASO Molinette, Istituto Radiologia Universitaria, Via Genova 3, 10126, Torino, Italy.
Radiol Med. 2009 Jun;114(4):595-607. doi: 10.1007/s11547-009-0385-7. Epub 2009 May 14.
The purpose of this study was to compare exposure of patient and operator to ionising radiation during percutaneous vertebroplasty performed under combined computed tomography (CT) and fluoroscopic guidance or fluoroscopic guidance alone.
With the collaboration of our physics department, we measured exposure on ten patients undergoing vertebroplasty with combined CT and fluoroscopic guidance and on ten undergoing vertebroplasty with fluoroscopic guidance alone.
Mean operator dose was approximately 0.8 microSv during vertebroplasty done with combined CT and fluoroscopic guidance and 5.8 microSv in procedures with fluoroscopic guidance alone. Mean patient dose was approximately 6 mSv for combined guidance and 8 mSv for fluoroscopic guidance, a difference that was not found to be statistically significant.
Although combined CT and fluoroscopic guidance is normally preferred for difficult areas such as the cervical and upper thoracic vertebrae, to ensure operator radiation protection, the technique should also be considered for areas normally treated under fluoroscopic guidance alone. However, a larger patient series is needed to correctly evaluate the real contribution of low-dose CT to patient exposure.
本研究旨在比较在计算机断层扫描（CT）与透视联合引导或仅透视引导下行经皮椎体成形术时患者和术者所接受的电离辐射剂量。
在我们物理科室的协作下，我们测量了10例接受CT与透视联合引导下椎体成形术患者以及10例仅接受透视引导下椎体成形术患者的辐射剂量。
在CT与透视联合引导下进行椎体成形术时，术者平均剂量约为0.8微希沃特，而仅透视引导下的手术中术者平均剂量为5.8微希沃特。联合引导时患者平均剂量约为6毫希沃特，透视引导时为8毫希沃特，未发现两者差异具有统计学意义。
尽管对于颈椎和上胸椎等困难部位通常首选CT与透视联合引导以确保术者的辐射防护，但对于通常仅在透视引导下治疗的部位也应考虑采用该技术。然而，需要更大规模的患者队列来正确评估低剂量CT对患者辐射剂量的实际影响。
