Universidade de Mogi das Cruzes, Mogi das Cruzes, São Paulo, Brazil.
Sapra Landauer, São Carlos, São Paulo, Brazil.
J Appl Clin Med Phys. 2009 Oct 7;10(4):252-259. doi: 10.1120/jacmp.v10i4.3007.
The quality assurance (QA) of radiographic images based on the operating conditions of X-ray equipment is essential for good image quality, accurate medical diagnostics and for the prevention of health professionals and patients to unnecessary doses of ionizing radiation. This paper presents a historical analysis of 1,635 Quality Assurance Technical Reports of Health Institutions in the state of São Paulo, Brazil, over a seven-year period. Based on acceptable limits for variations between nominal and measured parameters as the variable to determine the quality of X-ray equipment operating conditions, a significant improvement was found in the percentage of acceptance of the overall parameters described in the QA technical reports over this period. As expected, we found a strong concentration in the categories of conventional and portable X-ray equipment, which represent 72% and 84%, respectively, of the total number of equipments. A mechanical parameter such as half-value layer (HVL), which is important not only for image quality but also for radiation protection, showed significant improvements. Again, only 58% of portable X-ray equipment showed HVL values recommended for 80 kVp (above 2.3 mm Al), a percentage that improved to 76% in 2006. With regard to mammographers, which are newer machines, all the analyzed systems presented acceptable HVL values. Conventional X-ray machines showed an increase of this conformity index from 89% in 2000 to 94% in 2006. All this improvement was attributed to the continuous and extensive enforcement of Regulation Act 453 in the state of São Paulo. The improvement in equipment quality control standards is expected to result in the improvement of diagnostic quality, as well as in the reduction of exam repetitions, and thereby reducing the patient's exposure to radiation.
基于 X 射线设备运行条件的射线照相图像质量保证（QA）对于良好的图像质量、准确的医学诊断以及防止健康专业人员和患者受到不必要的电离辐射剂量至关重要。本文对巴西圣保罗州 1635 份卫生机构 QA 技术报告进行了历史分析，时间跨度为七年。基于名义参数和测量参数之间可接受的变化范围作为确定 X 射线设备运行条件质量的变量，在此期间，整体 QA 技术报告中描述的参数的接受率显著提高。正如预期的那样，我们发现常规和便携式 X 射线设备的比例很高，分别占设备总数的 72%和 84%。半值层（HVL）等机械参数不仅对图像质量而且对辐射防护都很重要，其结果显示出显著的改善。同样，只有 58%的便携式 X 射线设备的 HVL 值符合 80 kVp（高于 2.3mmAl）的建议值，这一比例在 2006 年提高到 76%。对于较新的乳腺 X 射线机，所有分析的系统均显示出可接受的 HVL 值。常规 X 射线机的这一符合指数从 2000 年的 89%增加到 2006 年的 94%。这一切的改进都归因于圣保罗州对第 453 号法规的持续广泛执行。设备质量控制标准的提高有望提高诊断质量，减少检查重复，从而降低患者的辐射暴露。
