Liebmann M, Lüllau T, Kluge A, Poppe B, von Boetticher H
Medical Radiation Physics, Carl von Ossietzky University, Oldenburg.
Institute for Diagnostic and Interventional Radiology, Pius-Hospital Oldenburg.
Rofo. 2014 Nov;186(11):1022-7. doi: 10.1055/s-0034-1366279. Epub 2014 Apr 1.
Although the use of thyroid shields for patients for head CT examinations is reasonable and even required by German regulations, so far available shields are often not used due to difficult applicability. New shields that are easier to use and therefore may gain wider acceptance and more frequent use are now available. In this work two new patient shields are investigated regarding their dose reduction effectiveness and applicability and compared to a thyroid/sternum shield typically used as a part of personal protective equipment.
The reduction of organ doses for thyroid, sternum and mamma were measured with thermoluminescence detectors in an anthropomorphic female phantom. Additionally, the influence of the length or position of the overview scan at the beginning of the CT examination was taken into account.
Depending on the patient shield, a reduction of the organ doses for thyroid of 5 - 24 %, for sternum of 25 - 48 % and for mamma of 25 - 70 % could be found. A shift of 25 mm in the cranial direction for the overview scan resulted in a reduction of these organ doses of 12 - 15 %.
Patient shields for cranial CT examinations provide a considerable dose reduction. New models are easily applied and no decrease in image quality through reconstruction artifacts could be found. Therefore, it is advised to use shields which are applied upon the patient without the need to be wrapped around the neck and the overview scan should be positioned as close as possible to the examined region.
• New shields provide a compromise between usability and radiation protection.• Patient shields reduce organ doses even when not directly exposed.• The overview scan contributes considerably to out of field organ doses.• Shielding factors are greatly influenced by the positioning of the examination field.
尽管为头部CT检查的患者使用甲状腺防护装置是合理的,甚至是德国法规所要求的,但由于适用性差,目前可用的防护装置常常未被使用。现在有了更易于使用的新型防护装置,因此可能会得到更广泛的接受和更频繁的使用。在本研究中,对两种新型患者防护装置的剂量降低效果和适用性进行了研究,并与通常作为个人防护设备一部分使用的甲状腺/胸骨防护装置进行了比较。
在一个女性人体模型中,用热释光探测器测量甲状腺、胸骨和乳腺的器官剂量减少情况。此外,还考虑了CT检查开始时全景扫描的长度或位置影响。
根据患者防护装置的不同,甲状腺器官剂量可降低5%-24%,胸骨剂量可降低25%-48%,乳腺剂量可降低25%-70%。全景扫描在头侧方向偏移25mm可使这些器官剂量降低12%-15%。
用于头部CT检查的患者防护装置可显著降低剂量。新型号易于应用,且未发现因重建伪影导致图像质量下降。因此,建议使用无需绕在患者颈部即可应用的防护装置,并且全景扫描应尽可能靠近检查区域定位。
• 新型防护装置在可用性和辐射防护之间取得了平衡。• 患者防护装置即使在未直接暴露时也能降低器官剂量。• 全景扫描对视野外器官剂量有很大影响。• 屏蔽因子受检查区域定位的极大影响。