Department of Radiology, Loma Linda University Medical Center, 11234 Anderson St., 2605 G Schuman Pavilion, Loma Linda, CA 92354, USA.
J Vasc Interv Radiol. 2011 Apr;22(4):431-6. doi: 10.1016/j.jvir.2011.01.431.
Computed tomography (CT) scans are a significant source of radiation to patients. It was hypothesized that technical success and complication rates would not be significantly changed by radically lowering the CT dose during lung biopsies with an ultra-low-dose (ULD) protocol.
A total of 100 consecutive patients aged 11-89 years who underwent biopsies of lung lesions were evaluated. Technical parameters were altered halfway through the study from the standard dose (140 kV localizing/100 kV subsequent guiding scans with auto-mA) to a ULD protocol (100 kV, 7.5 mAs) as part of a quality initiative. ULD studies were evaluated subjectively for image quality on a five-point scale. Patients' body mass indexes, total estimated radiation doses (dose-length product), technical success rates, and complications were compared between the standard-dose and the ULD groups.
Average radiation dose was reduced from 677.5 mGy·cm for the standard-dose group to 18.3 mGy·cm for the ULD group (P < .0001). In the ULD group, image quality was rated as adequate or better in 96% of cases. Pneumothoraces necessitating chest tube placements occurred in 10% and 6% of cases in the ULD and standard dose groups, respectively (P = .715). Technical success rates of 92% and 98% were obtained in the ULD and standard dose groups, respectively (P = .362).
Radiation dose to the chest during CT-guided percutaneous lung biopsies is reduced greater than 95% versus a standard protocol through the use of a ULD CT protocol without decreasing technical success or patient safety.
计算机断层扫描（CT）是患者辐射的重要来源。本研究假设通过超低剂量（ULD）方案在进行肺活检时大幅降低 CT 剂量，其技术成功率和并发症发生率不会显著改变。
共评估了 100 例年龄在 11-89 岁之间行肺部病变活检的连续患者。作为质量改进的一部分，在研究中途将技术参数从标准剂量（局部 140 kV/后续引导扫描 100 kV 自动 mA）更改为 ULD 方案（100 kV，7.5 mAs）。ULD 研究的图像质量通过五分制进行主观评估。比较标准剂量组和 ULD 组患者的体重指数、总估计辐射剂量（剂量长度乘积）、技术成功率和并发症。
标准剂量组的平均辐射剂量从 677.5 mGy·cm 降低至 ULD 组的 18.3 mGy·cm（P <.0001）。ULD 组 96%的病例图像质量被评为足够或更好。ULD 组和标准剂量组分别有 10%和 6%的病例需要放置胸腔引流管治疗气胸（P =.715）。ULD 组和标准剂量组的技术成功率分别为 92%和 98%（P =.362）。
与标准方案相比，通过使用 ULD CT 方案，可使 CT 引导经皮肺活检时胸部的辐射剂量降低 95%以上，而不会降低技术成功率或患者安全性。
