Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
Department of Radiology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03766, USA.
Dysphagia. 2022 Apr;37(2):399-406. doi: 10.1007/s00455-021-10291-7. Epub 2021 Apr 23.
Modified Barium Swallow Studies (MBSSs) are important tests to aid the diagnosis of swallowing impairment and guide treatment planning. Since MBSSs use ionizing radiation, it is important to understand the radiation exposure associated with the exam. This study reports the average radiation dose in routine clinical MBSSs, to aid the evidence-based decision-making of clinical providers and patients. We examined the MBSSs of 200 consecutive adult patients undergoing clinically indicated exams and used kilovoltage (kV) and Kerma Area Product to calculate the effective dose. While 100% of patients underwent the exam in the lateral projection, 72% were imaged in the upper posterior-anterior (PA) projection and approximately 25% were imaged in the middle and lower PA projection. Average kVs were 63 kV, 77 kV, 78.3 kV, and 94.3 kV, for the lateral, upper, middle, and lower PA projections, respectively. The average effective dose per exam was 0.32 ± 0.23 mSv. These results categorize a typical adult MBSS as a low dose examination. This value serves as a general estimate for adults undergoing MBSSs and can be used to compare other sources of radiation (environmental and medical) to help clinicians and patients assess the risks of conducting an MBSS. The distinction of MBSS as a low dose exam will assuage most clinician's fears, allowing them to utilize this tool to gather clinically significant information about swallow function. However, as an X-ray exam that uses ionizing radiation, the principles of ALARA and radiation safety must still be applied.
改良钡吞咽研究（MBSS）是辅助吞咽障碍诊断和指导治疗计划的重要检查。由于 MBSS 使用电离辐射，因此了解与检查相关的辐射暴露非常重要。本研究报告了常规临床 MBSS 中的平均辐射剂量，以帮助临床医生和患者做出基于证据的决策。我们检查了 200 例连续进行临床指征检查的成年患者的 MBSS，并使用千伏（kV）和比释动能面积来计算有效剂量。虽然 100%的患者在侧位进行了检查，但 72%的患者在高位后前位（PA）进行了成像，大约 25%的患者在中低位 PA 进行了成像。侧位、高位、中位和低位 PA 投影的平均 kV 值分别为 63 kV、77 kV、78.3 kV 和 94.3 kV。每次检查的平均有效剂量为 0.32±0.23 mSv。这些结果将典型的成人 MBSS 归类为低剂量检查。该值可作为成人进行 MBSS 的一般估计值，并可用于将其他来源的辐射（环境和医疗）与比较，以帮助临床医生和患者评估进行 MBSS 的风险。将 MBSS 区分开来作为低剂量检查将消除大多数临床医生的担忧，使他们能够利用该工具收集有关吞咽功能的临床重要信息。然而，作为使用电离辐射的 X 射线检查，仍然必须应用 ALARA 和辐射安全原则。
