Deak Zsuzsanna, Brummund Lindis, Kirchhoff Sonja, Körner Markus, Geyer Lucas, Mück Fabian, Scaglione Mariano, Reiser Maximilian, Linsenmaier Ulrich
Imaging Urania, Laurenzenberg 2, 1010 Wien, Austria.
Departmant of Radiology, University Hospital LMU, Marchioninistraße 15, 81377 Munich, Germany.
Diagnostics (Basel). 2022 Aug 2;12(8):1872. doi: 10.3390/diagnostics12081872.
The purpose of this experimental study on recently deceased human cadavers was to investigate whether (I) the radiation exposure of the cervical spine CT can be reduced comparable to a dose level of conventional radiography (CR); and (II) whether and which human body parameters can be predictive for higher dose reduction potential (in this context).
Seventy serial CT scans of the cervical spine of 10 human cadavers undergoing postmortem virtual autopsy were taken using stepwise decreasing upper limits of the tube current (300 mAs, 150 mAs, 110 mAs, 80 mAs, 60 mAs, 40 mAs, and 20 mAs) at 120 kVp. An additional scan acquired at a fixed tube current of 300 mAs served as a reference. Images were reconstructed with filtered back projection and the upper (C1-4) and lower (C4-7) cervical spine were evaluated by three blinded readers for image quality, regarding diagnostic value and resolution of anatomical structures according to a semiquantitative three-point-scale. Dose values and individual physical parameters were recorded. The relationship of diagnostic IQ, dose reduction level, and patients' physical parameters were investigated. The high-contrast resolution of the applied CT protocols was tested in an additional phantom study.
The IQ of the upper cervical spine was diagnostic at 1.69 ± 0.58 mGy (CTDI) corresponding to 0.20 ± 0.07 mSv (effective dose) in all cadavers. IQ of the lower cervical spine was diagnostic at 4.77 ± 1.86 mGy corresponding to 0.560 ± 0.21 mSv (effective dose) in seven cadavers and at 2.60 ± 0.93 mGy corresponding to 0.31 ± 0.11 mSv in four cadavers. Significant correlation was detected for BMI (0.8366; = 0.002548) and the anteroposterior (a.p.) chest diameter (0.8363; = 0.002566), shoulder positioning (0.79799; = 0.00995), and radiation exposure.
Conventional radiography can be replaced with a nearly dose-neutral CT scan of the cervical spine.
本针对近期死亡人类尸体的实验性研究目的在于探究：（I）颈椎CT的辐射暴露是否能降低至与传统X线摄影（CR）剂量水平相当；以及（II）人体哪些参数能够预测更高的剂量降低潜力（在此背景下）。
对10具进行死后虚拟尸检的人类尸体的颈椎进行70次连续CT扫描，在120 kVp下逐步降低管电流上限（300 mAs、150 mAs、110 mAs、80 mAs、60 mAs、40 mAs和20 mAs）。另外在固定管电流300 mAs下进行的一次扫描作为参考。图像采用滤波反投影重建，由三位不知情的阅片者根据半定量三点量表对颈椎上部（C1 - 4）和下部（C4 - 7）的图像质量进行评估，评估内容包括解剖结构的诊断价值和分辨率。记录剂量值和个体身体参数。研究诊断图像质量、剂量降低水平与患者身体参数之间的关系。在另一项体模研究中测试所应用CT协议的高对比度分辨率。
所有尸体颈椎上部的图像质量在CT剂量指数（CTDI）为1.69±0.58 mGy（对应有效剂量0.20±0.07 mSv）时具有诊断性。七具尸体颈椎下部的图像质量在CTDI为4.77±1.86 mGy（对应有效剂量0.560±0.21 mSv）时具有诊断性，四具尸体在CTDI为2.60±0.93 mGy（对应有效剂量0.31±0.11 mSv）时具有诊断性。检测到体重指数（BMI）（0.8366；P = 0.002548）、胸部前后径（0.8363；P = 0.002566）、肩部位置（0.79799；P = 0.00995）与辐射暴露之间存在显著相关性。
颈椎的近乎剂量中性的CT扫描可替代传统X线摄影。
