From the St. Michael's Hospital.
Michener Institute of Education at UHN, Toronto, Ontario, Canada.
Invest Radiol. 2021 Mar 1;56(3):135-140. doi: 10.1097/RLI.0000000000000716.
Chest radiography is often used to detect lung involvement in patients with suspected pneumonia. Chest radiography through glass walls of an isolation room is a technique that could be immensely useful in the current COVID-19 pandemic.
The purpose of this study was to ensure quality and radiation safety while acquiring portable chest radiographs through the glass doors of isolation rooms using an adult anthropomorphic thorax phantom.
Sixteen chest radiographs were acquired utilizing different exposure factors without glass, through the smart glass, and through regular glass. Images were scored independently by 2 radiologists for quantum mottle and sharpness of anatomical structures using a 5-point Likert scale. Statistically significant differences in Likert scale scores and entrance surface dose (ESD) between images acquired without glass and through the smart and regular glass were tested. Interreader reliability was also evaluated.
Compared with conventional radiography, equal or higher mean image quality scores (mottle and anatomical structures) were observed with the smart glass using 100 kVp at 12 mAs and 20 mAs and 125 kVp at 6.3 mAs (100 kVp at 2 mAs and 125 kVp at 3.2 mAs were used for conventional radiography observations). There was no statistically significant difference in the Likert scale scores for image quality and the entrance surface dose for radiographs acquired without glass, through the smart glass, and through regular glass. Backscatter from the smart glass was minimal at a distance of 3 m and was recorded as zero at a distance of 4 m from the x-ray tube outside an isolation room.
Good-quality portable chest radiographs can be obtained safely through the smart glass doors of the isolation room. However, this technique does result in minor backscatter radiation. Modifications in the exposure factors (such as increasing milliampere seconds) may be required to optimize image quality while using this technique.
胸部 X 光检查常用于检测疑似肺炎患者肺部的受累情况。通过隔离室的玻璃墙进行胸部 X 光检查是一种在当前 COVID-19 大流行中非常有用的技术。
本研究的目的是使用成人胸部体模，确保在通过隔离室的玻璃门获取便携式胸部 X 光时的质量和辐射安全。
利用不同的曝光参数，在不使用玻璃、通过智能玻璃和普通玻璃的情况下获取了 16 张胸部 X 光片。由 2 位放射科医生独立使用 5 分制 Likert 量表对量子斑点和解剖结构的清晰度进行评分。对不使用玻璃和通过智能玻璃和普通玻璃获取的图像之间的 Likert 量表评分和体表剂量（ESD）进行了统计学差异检验。还评估了读者间的可靠性。
与常规 X 射线摄影相比，使用 100 kVp 时的 12 mAs 和 20 mAs 以及 125 kVp 时的 6.3 mAs（常规 X 射线摄影观察时使用 100 kVp 时的 2 mAs 和 125 kVp 时的 3.2 mAs），智能玻璃可以获得同等或更高的平均图像质量评分（斑点和解剖结构）。在不使用玻璃、通过智能玻璃和通过普通玻璃获取的 X 光片之间，图像质量的 Likert 量表评分和体表剂量没有统计学差异。在距离 X 射线管 3 米处，智能玻璃的背散射最小，在隔离室外距离 X 射线管 4 米处记录为零。
可以安全地通过隔离室的智能玻璃门获得高质量的便携式胸部 X 光片。但是，这种技术确实会导致轻微的背散射辐射。可能需要修改曝光参数（例如增加毫安秒）以优化使用该技术时的图像质量。
