Gange Christopher P, Pahade Jay K, Cortopassi Isabel, Bader Anna S, Bokhari Jamal, Hoerner Matthew, Thomas Kelly M, Rubinowitz Ami N
Department of Radiology, Biomedical Imaging, Yale School of Medicine, PO Box 208042, Tompkin's East 2, New Haven, CT 06520.
Radiol Cardiothorac Imaging. 2020 Nov 12;2(6):e200420. doi: 10.1148/ryct.2020200420. eCollection 2020 Dec.
To develop a technique that allows portable chest radiography to be performed through the glass door of a patient's room in the emergency department.
A retrospective review of 100 radiographs (50 [mean age 59.4 ± 17.3, range 22-87; 30 women] performed with the modified technique in April 2020, randomized with 50 [mean age 59 ± 21.6, range 19-100; 31 men] using the standard technique was completed by three thoracic radiologists to assess image quality. Radiation exposure estimates to patient and staff were calculated. A survey was created and sent to 32 x-ray technologists to assess their perceptions of the modified technique. Unpaired Ttests were used for numerical data. value < .05 was considered statistically significant.
The entrance dose for a 50th percentile patient was the same between techniques, measuring 169 µGy. The measured technologist exposure from the modified technique assuming a 50th percentile patient and standing 6 feet to the side of the glass was 0.055 µGy, which was lower than standard technique technologist exposure of 0.088 µGy. Of the 100 portable chest radiographs evaluated by three reviewers, two reviewers rated all images as having diagnostic quality, while the other reviewer believed two of the standard images and one of the modified technique images were non-diagnostic. A total of 81% (26 of 32) of eligible technologists completed the survey. Results showed acceptance of the modified technique with the majority feeling safer and confirming conservation of PPE. Most technologists did not feel the modified technique was more difficult to perform.
The studies acquired with the new technique remained diagnostic, patient radiation doses remained similar, and technologist dose exposure were decreased with modified positioning. Perceptions of the new modified technique by frontline staff were overwhelmingly positive.
开发一种技术，使便携式胸部X光检查能够通过急诊科患者病房的玻璃门进行。
三位胸科放射科医生对100张X光片进行了回顾性研究（2020年4月采用改良技术拍摄50张[平均年龄59.4±17.3岁，范围22 - 87岁；30名女性]，随机选取50张[平均年龄59±21.6岁，范围19 - 100岁；31名男性]采用标准技术拍摄）以评估图像质量。计算了患者和工作人员的辐射暴露估计值。创建了一项调查并发送给32名X光技师，以评估他们对改良技术的看法。对数值数据采用非配对T检验。P值<0.05被认为具有统计学意义。
两种技术下第50百分位患者的入射剂量相同，均为169微戈瑞。假设第50百分位患者且站在玻璃门一侧6英尺处，改良技术测得的技师暴露剂量为0.055微戈瑞，低于标准技术技师暴露剂量0.088微戈瑞。在三位评审员评估的100张便携式胸部X光片中，两位评审员将所有图像评为具有诊断质量，而另一位评审员认为两张标准技术图像和一张改良技术图像无法诊断。共有81%（32名中的26名）符合条件的技师完成了调查。结果显示对改良技术的接受度较高，大多数人感觉更安全并确认个人防护装备得到了节省。大多数技师不认为改良技术更难操作。
新技术获取的研究结果仍具有诊断性，患者辐射剂量保持相似，改良定位后技师的剂量暴露有所降低。一线工作人员对新改良技术的看法总体上是积极的。
