Pötter-Lang S, Dünkelmeyer M, Uffmann M
Universitätsklinik für Radiodiagnostik, Medizinische Universität Wien, Währinger Gürtel 18-20, A-1090, Wien, Österreich.
Radiologe. 2012 Oct;52(10):898-904. doi: 10.1007/s00117-012-2337-9.
CLINICAL/METHODICAL ISSUE: Dose reduction and adequate image quality in digital radiography - a contradiction?
Digital radiography has already replaced traditional screen-film systems.
Substantial improvements in both dose efficiency and spatial resolution demonstrate the rapid developments in digital radiography.
Needle-detector systems have shown up to a 50% dose reduction compared to traditional screen-film systems. There is also a dose reduction capability of up to 50% comparing direct radiography (DR) systems to computed radiography (CR) systems for chest X-rays. However, despite the most recent achievements of CR technology, the dose efficiency of DR systems (caesium iodide flat-panel detector) is unparalleled.
The progress in detector technology has contributed to dose reduction and improved image quality, while saving time and providing a higher examination rate.
The use of dose indicators and longitudinal dose control are important to avoid substantial accidental dose increase. The dose applied to patients should fall markedly below the defined diagnostic reference levels within the European Union. Regular quality control, as well as continuous education and training of medical and technical personnel, contribute to ensure that the ALARA (as low as reasonably achievable) principle is consistently followed.
临床/方法学问题：数字X线摄影中的剂量降低与足够的图像质量——相互矛盾吗？
数字X线摄影已取代传统的屏-片系统。
剂量效率和空间分辨率的显著提高证明了数字X线摄影的快速发展。
与传统屏-片系统相比，针状探测器系统的剂量降低了50%。对于胸部X线摄影，直接X线摄影（DR）系统与计算机X线摄影（CR）系统相比，剂量降低能力也高达50%。然而，尽管CR技术取得了最新进展，但DR系统（碘化铯平板探测器）的剂量效率无与伦比。
探测器技术的进步有助于降低剂量、提高图像质量，同时节省时间并提高检查率。
使用剂量指示器和纵向剂量控制对于避免剂量意外大幅增加很重要。应用于患者的剂量应明显低于欧盟规定的诊断参考水平。定期进行质量控制，以及对医疗和技术人员进行持续教育和培训，有助于确保始终遵循ALARA（尽可能合理低）原则。
