Sánchez Adrian A, Reiser Ingrid, Baxter Tina, Zhang Yue, Finkle Joshua H, Lu Zheng Feng, Feinstein Kate A
Department of Radiology, The University of Chicago Medical Center, 5841 S. Maryland Ave., MC2026, Chicago, IL, 60637, USA.
Pediatr Radiol. 2018 Feb;48(2):210-215. doi: 10.1007/s00247-017-4025-4. Epub 2017 Nov 12.
Default pediatric protocols on many digital radiography systems are configured based on patient age. However, age does not adequately characterize patient size, which is the principal determinant of proper imaging technique. Use of default pediatric protocols by inexperienced technologists can result in patient overexposure, inadequate image quality, or repeated examinations.
To ensure diagnostic image quality at a well-managed patient radiation exposure by transitioning to thickness-based protocols for pediatric portable abdomen radiography.
We aggregated patient thickness data, milliamperes (mAs), kilovoltage peak (kVp), exposure index (EI), source-to-detector distance, and grid use for all portable abdomen radiographs performed in our pediatric hospital in a database with a combination of automated and manual data collection techniques. We then analyzed the database and used it as the basis to construct thickness-based protocols with consistent image quality across varying patient thicknesses, as determined by the EI.
Retrospective analysis of pediatric portable exams performed at our adult-focused hospitals demonstrated substantial variability in EI relative to our pediatric hospital. Data collection at our pediatric hospital over 4 months accumulated roughly 800 portable abdomen exams, which we used to develop a thickness-based technique chart.
Through automated retrieval of data in our systems' digital radiography exposure logs and recording of patient abdomen thickness, we successfully developed thickness-based techniques for portable abdomen radiography.
许多数字放射成像系统上的默认儿科协议是根据患者年龄配置的。然而，年龄并不能充分体现患者的体型，而体型是合适成像技术的主要决定因素。 inexperienced technologists使用默认儿科协议可能会导致患者过度曝光、图像质量不足或需要重复检查。
通过过渡到基于厚度的儿科便携式腹部放射成像协议，在合理控制患者辐射剂量的情况下确保诊断图像质量。
我们汇总了在我院儿科进行的所有便携式腹部X光片的患者厚度数据、毫安（mAs）、峰值千伏（kVp）、曝光指数（EI）、源到探测器距离和滤线栅使用情况，采用自动和手动数据收集技术相结合的方式存入数据库。然后我们对数据库进行分析，并以此为基础构建基于厚度的协议，确保在不同患者厚度下都有一致的图像质量，图像质量由EI确定。
对在以成人为主的医院进行的儿科便携式检查的回顾性分析表明，相对于我院儿科，EI存在很大差异。我院儿科在4个月内收集的数据积累了大约800次便携式腹部检查，我们用这些数据制定了基于厚度的技术图表。
通过自动检索系统数字放射成像曝光日志中的数据并记录患者腹部厚度，我们成功开发了基于厚度的便携式腹部放射成像技术。
