Department of Radiology, Changi General Hospital, Singapore.
Ann Acad Med Singap. 2018 Aug;47(8):278-284.
In this study, we aimed to compare the split-bolus and single-bolus computerised tomography (CT) urography and determine if this offers a reduction in radiation dose without compromising image quality.
A retrospective evaluation was performed on 88 patients undergoing split-bolus CT urography and this was compared to a control group of 101 consecutive patients undergoing single-bolus CT urography. A radiation dose analysis was performed on each subject. Subjects with urinary bladder lesions, hydronephrosis, renal masses or cysts >3 cm in diameter were excluded. All images were classified according to image quality by 2 consultant radiologists.
Opacification of the renal parenchyma, pelvicalyceal system, proximal ureters and urinary bladder were comparable between the 2 techniques, whilst image quality of the middle and distal third of the ureters was better using the split-bolus technique. The mean dose length product (DLP) for the single-bolus technique was 1324.1 mGy-cm, whilst that of the split-bolus technique was 885.7 mGy-cm. The mean effective dose reduction was calculated to be 31.1% between the 2 groups.
The split-bolus technique gives a reduced radiation dose without compromising image quality. The associated reduction in images is beneficial for data storage and reporting efficiency. As such, our department will adopt the split-bolus technique for young, low-risk patients.
本研究旨在比较分次团注与单次团注计算机断层尿路造影，并确定在不影响图像质量的情况下，是否可以降低辐射剂量。
回顾性分析 88 例行分次团注 CT 尿路造影的患者，并与 101 例行单次团注 CT 尿路造影的连续患者进行比较。对每位患者进行辐射剂量分析。排除有膀胱病变、肾盂积水、肾肿块或直径>3cm 的囊肿的患者。所有图像均由 2 位顾问放射科医生根据图像质量进行分类。
两种技术的肾实质、肾盂肾盏系统、近端输尿管和膀胱充盈均相似，而使用分次团注技术时，输尿管中、下段的图像质量更好。单次团注技术的平均剂量长度乘积（DLP）为 1324.1 mGy-cm，而分次团注技术的 DLP 为 885.7 mGy-cm。两组之间的平均有效剂量减少率计算为 31.1%。
分次团注技术可降低辐射剂量，而不影响图像质量。相关图像减少有利于数据存储和报告效率。因此，我们科室将为年轻、低风险的患者采用分次团注技术。
