与传统 CT 相比，髋关节保护手术中低剂量 CT 可将辐射暴露降低 90%。
Low-Dose Computed Tomography Reduces Radiation Exposure by 90% Compared With Traditional Computed Tomography Among Patients Undergoing Hip-Preservation Surgery.
机构信息
Department of Orthopaedic Surgery, Washington University in St Louis, St Louis, Missouri, U.S.A.
Mallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, Missouri, U.S.A.
出版信息
Arthroscopy. 2019 May;35(5):1385-1392. doi: 10.1016/j.arthro.2018.11.013. Epub 2019 Apr 12.
PURPOSE
To compare the delivered radiation dose between a low-dose hip computed tomography (CT) scan protocol and traditional hip CT scan protocols (i.e., "traditional CT").
METHODS
This was a retrospective comparative cohort study. Patients who underwent hip-preservation surgery (including arthroscopy, surgical hip dislocation, or periacetabular osteotomy procedures) at our institution between 2016 and 2017 were identified. Patients were excluded if they had a body mass index (BMI) greater than 35, they underwent previous surgery, or a radiation dose report was absent. The low-dose group included patients who underwent hip CT at our institution using a standardized protocol of 100 kV (peak), 100 milliampere-seconds (mAs), and a limited scanning field. The traditional CT group included patients who had hip CT scans performed at outside institutions. The total effective dose (E), effective dose per millimeter of body length scanned, patients' age, and patients' BMI were compared by univariate analysis. The correlation of E to BMI was assessed.
RESULTS
The study included 41 consecutive patients in the low-dose group and 18 consecutive patients in the traditional CT group. Low-dose CT resulted in a 90% reduction in radiation exposure compared with traditional CT (E, 0.97 ± 0.28 mSv vs 9.68 ± 6.67 mSv; P < .0001). Age (28 ± 11 years vs 26 ± 10 years, P = .42), sex (83% female patients vs 76% female patients, P = .74), and BMI (24 ± 3 vs 24 ± 3, P = .75) were not different between the 2 groups. E had a poor but significant correlation to BMI in the low-dose CT group (R = 0.14, slope = 0.03, P = .02) and did not correlate to BMI in the traditional CT group (R = 0.13, P = .14).
CONCLUSIONS
A low-dose hip CT protocol for the purpose of hip-preservation surgical planning resulted in a 90% reduction in radiation exposure compared with traditional CT.
LEVEL OF EVIDENCE
Level II, diagnostic study.
目的
比较低剂量髋关节 CT 扫描方案与传统髋关节 CT 扫描方案（即“传统 CT”）之间的辐射剂量。
方法
这是一项回顾性对比队列研究。在我院接受髋关节保留手术（包括关节镜、手术髋关节脱位或髋臼周围截骨术）的患者于 2016 年至 2017 年被确定为研究对象。排除体重指数（BMI）大于 35 者、有既往手术史者或无辐射剂量报告者。低剂量组包括在我院采用 100kV（峰值）、100 毫安秒（mAs）和有限扫描场的标准化方案进行髋关节 CT 检查的患者。传统 CT 组包括在我院外进行髋关节 CT 检查的患者。采用单因素分析比较总有效剂量（E）、每毫米扫描长度的有效剂量、患者年龄和患者 BMI。评估 E 与 BMI 的相关性。
结果
低剂量组纳入 41 例连续患者，传统 CT 组纳入 18 例连续患者。与传统 CT 相比，低剂量 CT 使辐射暴露降低了 90%（E，0.97±0.28mSv 比 9.68±6.67mSv；P<0.0001）。两组间年龄（28±11 岁比 26±10 岁，P=0.42）、性别（83%女性患者比 76%女性患者，P=0.74）和 BMI（24±3 比 24±3，P=0.75）无差异。低剂量 CT 组 E 与 BMI 呈弱但有统计学意义的相关性（R=0.14，斜率=0.03，P=0.02），而传统 CT 组 E 与 BMI 无相关性（R=0.13，P=0.14）。
结论
用于髋关节保留手术计划的低剂量髋关节 CT 方案与传统 CT 相比，辐射暴露降低了 90%。
证据水平
Ⅱ级，诊断性研究。
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