Zinsser Dominik, Maurer Michael, Do Phuong-Linh, Weiß Jakob, Notohamiprodjo Mike, Bamberg Fabian, Othman Ahmed E
Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.
BMC Med Imaging. 2019 Jan 11;19(1):4. doi: 10.1186/s12880-019-0304-x.
To evaluate a reduced range CT protocol in patients with suspected acute appendicitis as compared to standard abdominal CT regarding diagnostic performance, effective radiation dose and organ doses.
In this study, we retrospectively included 90 patients (43 female, mean age 56.7 ± 17 years) with suspected acute appendicitis who underwent CT of abdomen and pelvis. From those CTs, we reconstructed images with a reduced scan range from L1 to the the pubic symphysis. Full range and reduced range datasets were assessed by two radiologists for i) coverage of the Appendix, ii) presence/absence of appendicitis and iii) presence of differential diagnoses. Furthermore, effective radiation doses as well as organ doses were calculated using a commercially available dose management platform (Radimetrics, Bayer HealthCare).
The Appendix was covered by the reduced range CT in all cases. In 66 patients CT confirmed the presence of appendicitis. In 14 patients, other relevant differential diagnoses were identified by CT, whereas in 10 patients no relevant findings were detected. Both readers identified all patients with appendicitis on both full and reduced range CT. For reduced range CT, total effective dose was 39% lower than for full range CT (reduced range: 4.5 [1.9-11.2] vs. full range: 7.4 [3.3-18.8] mSv; p ≤ 0.001). Notably, a remarkable reduction of organ dose in the female breasts by 97% (0.1 [0.1-0.6] vs. 3.8 [0.5-18.8] mSv; p ≤ 0.001) and in the testicles in males by 81% (3.4 [0.7-32.7] vs. 17.6 [5.4-52.9] mSv; p ≤ 0.001) was observed for reduced range CT compared to full range CT.
In patients with suspected acute appendicitis, reduced range abdominopelvic CT results in a comparable diagnostic performance with a remarkable reduction of total effective radiation dose and organ doses (especially breast dose in female and testicle dose in male patients) as compared to full range CT.
与标准腹部CT相比，评估针对疑似急性阑尾炎患者的缩小扫描范围CT方案在诊断性能、有效辐射剂量和器官剂量方面的情况。
在本研究中，我们回顾性纳入了90例疑似急性阑尾炎且接受腹部和盆腔CT检查的患者（43例女性，平均年龄56.7±17岁）。从这些CT图像中，我们重建了从L1至耻骨联合的缩小扫描范围的图像。两位放射科医生对全范围和缩小范围的数据集进行评估，内容包括：i）阑尾的覆盖情况；ii）阑尾炎的有无；iii）鉴别诊断的存在情况。此外，使用市售剂量管理平台（Radimetrics，拜耳医疗保健公司）计算有效辐射剂量以及器官剂量。
所有病例中缩小范围CT均覆盖了阑尾。66例患者的CT证实存在阑尾炎。14例患者经CT发现了其他相关鉴别诊断，而10例患者未检测到相关发现。两位阅片者在全范围和缩小范围CT上均识别出了所有阑尾炎患者。对于缩小范围CT，总有效剂量比全范围CT低39%（缩小范围：4.5 [1.9 - 11.2] vs. 全范围：7.4 [3.3 - 18.8] mSv；p≤0.001）。值得注意的是，与全范围CT相比，缩小范围CT使女性乳房的器官剂量显著降低了97%（0.1 [0.1 - 0.6] vs. 3.8 [0.5 - 18.8] mSv；p≤0.001），男性睾丸的器官剂量降低了81%（3.4 [0.7 - 32.7] vs. 17.6 [5.4 - 52.9] mSv；p≤0.001）。
对于疑似急性阑尾炎患者，与全范围CT相比，缩小范围的腹部盆腔CT具有相当的诊断性能，同时总有效辐射剂量和器官剂量（尤其是女性的乳房剂量和男性患者的睾丸剂量）显著降低。
