Chang C Y, Simeone F J, DeLorenzo M C, Palmer W E, Bredella M A, Huang A J
Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street Yawkey 6E, Boston, MA, 02114, USA.
Division of Diagnostic Imaging Physics, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street Yawkey 6E, Boston, MA, 02114, USA.
Skeletal Radiol. 2018 Feb;47(2):223-231. doi: 10.1007/s00256-017-2788-1. Epub 2017 Oct 13.
To demonstrate fluoroscopy dose reduction through both simulated injections on a phantom and patient injections.
Our study was IRB-approved and HIPAA-compliant. Simulation on a phantom was used to estimate effective dose, entrance dose, and organ doses for hip joint injections without and with dose minimization technique (DMT). Additionally, 1,094 joint, bursae, and tendon sheath injections performed by three operators in the same fluoroscopy suite were evaluated both before and after application of DMT. Fluoroscopy time (FT), dose, and dose area product (DAP) of injections were compared using unpaired t-tests with P > 0.05 considered statistically significant.
For the phantom simulation comparing injections without DMT and with DMT, the total DAP was 191.7 vs 18.7 μGy·m, and the entrance dose was 10.2 vs 3.6 mGy, respectively. For both men and women, DMT reduces effective dose and organ doses. For all injections, the FT (0.7 to 0.2 min), dose (5.6 to 1.9 mGy), and DAP (56.9 to 19.1 μGy·m) for all three operators decreased with DMT and remained statistically significant when stratified by the two most common injections, glenohumeral and hip joint injections (P < 0.05).
FT, effective dose, entrance dose, and DAP can be reduced with the use of simple easy-to-learn techniques, which will benefit both the patient and the radiologist.
通过在体模上模拟注射以及对患者进行注射来证明透视剂量的降低。
我们的研究获得了机构审查委员会（IRB）的批准且符合健康保险流通与责任法案（HIPAA）。在体模上进行模拟以估计在不使用和使用剂量最小化技术（DMT）的情况下髋关节注射的有效剂量、入射剂量和器官剂量。此外，对在同一透视检查室由三名操作人员进行的1094次关节、滑囊和腱鞘注射在应用DMT前后进行了评估。使用不成对t检验比较注射的透视时间（FT）、剂量和剂量面积乘积（DAP），P>0.05被认为具有统计学意义。
对于在体模模拟中比较不使用DMT和使用DMT的注射，总DAP分别为191.7与18.7μGy·m，入射剂量分别为10.2与3.6mGy。对于男性和女性，DMT均降低了有效剂量和器官剂量。对于所有注射，三名操作人员的FT（从0.7至0.2分钟）、剂量（从5.6至1.9mGy）和DAP（从56.9至19.1μGy·m）在使用DMT后均下降，并且在按两种最常见的注射（肩关节和髋关节注射）分层时仍具有统计学意义（P<0.05）。
使用简单易学的技术可以降低FT、有效剂量、入射剂量和DAP，这将使患者和放射科医生都受益。
