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儿科神经影像中计算机断层扫描辐射剂量降低策略。

Strategies for Computed Tomography Radiation Dose Reduction in Pediatric Neuroimaging.

作者信息

Albert Gregory W, Glasier Charles M

机构信息

*Division of Neurosurgery, ‡Department of Radiology, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, Arkansas.

出版信息

Neurosurgery. 2015 Aug;77(2):228-32; discussion 232. doi: 10.1227/NEU.0000000000000764.

Abstract

BACKGROUND

Radiation exposure from diagnostic imaging is a significant concern, particularly in the care of pediatric patients. Computed tomography (CT) scanning is a significant source of radiation.

OBJECTIVE

To demonstrate that diagnostic quality CT images can be obtained while minimizing the effective radiation dose to the patient.

METHODS

In this retrospective cross-sectional study, noncontrast head CT scan data were reviewed, and indications for scans and estimated radiation dose delivered were recorded. The estimated effective radiation dose (EERD) for each CT protocol was reviewed.

RESULTS

We identified 251 head CT scans in a single month. Of these, 96 scans were using a low-dose shunt protocol with a mean EERD of 0.82 mSv. The remaining 155 scans were performed using the standard protocol, and the mean EERD was 1.65 mSv. Overall, the EERD was minimized while maintaining diagnostic scan quality.

CONCLUSION

Although replacing a CT with magnetic resonance imaging is ideal to completely avoid ionizing radiation, this is not always practical or preferred. Therefore, it is important to have CT protocols in place that minimize radiation dose without sacrificing diagnostic quality. The protocols in place at our institution could be replicated at other academic and community hospitals and imaging centers.

摘要

背景

诊断性成像的辐射暴露是一个重大问题,尤其是在儿科患者的护理中。计算机断层扫描(CT)是辐射的一个重要来源。

目的

证明在将患者的有效辐射剂量降至最低的同时,可以获得具有诊断质量的CT图像。

方法

在这项回顾性横断面研究中,对非增强头部CT扫描数据进行了审查,并记录了扫描的指征和估计的辐射剂量。对每个CT方案的估计有效辐射剂量(EERD)进行了审查。

结果

我们在一个月内识别出251例头部CT扫描。其中,96例扫描采用低剂量分流方案,平均EERD为0.82 mSv。其余155例扫描采用标准方案,平均EERD为1.65 mSv。总体而言,在保持诊断扫描质量的同时,EERD降至最低。

结论

虽然用磁共振成像取代CT是完全避免电离辐射的理想选择,但这并不总是可行或首选的。因此,制定能在不牺牲诊断质量的前提下将辐射剂量降至最低的CT方案很重要。我们机构采用的方案可在其他学术和社区医院及影像中心推广。

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