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最新代血管造影系统在急性脑卒中患者中的有效剂量测量:与最新多排 CT 一代的比较。

Effective Dose Measurements of the Latest-Generation Angiographic System in Patients with Acute Stroke: A Comparison with the Newest Multidetector CT Generation.

机构信息

From the Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland

From the Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.

出版信息

AJNR Am J Neuroradiol. 2022 Nov;43(11):1621-1626. doi: 10.3174/ajnr.A7658. Epub 2022 Oct 6.

Abstract

BACKGROUND AND PURPOSE

Patients with acute ischemic stroke are increasingly triaged with one-stop management approaches, resulting in baseline imaging with a flat detector CT scanner. This study aimed to estimate the effective dose to a patient of a novel cervical and intracranial flat detector CT angiography and a flat detector CT perfusion protocol and to compare it with the effective dose of analogous multidetector row CT protocols.

MATERIALS AND METHODS

We estimated the effective dose to the patient according to the International Commission on Radiological Protection 103 using an anthropomorphic phantom with metal oxide semiconductor field effect transistor dosimeters. Placement was according to the organ map provided by the phantom manufacturer. We used 100 measurement points within the phantom, and 18 metal oxide semiconductor field effect transistor dosimeters were placed on the surface of the phantom. All protocols followed the manufacturer's specifications, and patient positioning and collimation were performed as in routine clinical practice. Measurements were obtained on the latest-generation angiography and multidetector row CT systems with identical placement of the metal oxide semiconductor field effect transistor dosimeters.

RESULTS

The estimated effective doses of the investigated perfusion protocols were 4.52 mSv (flat detector CT perfusion without collimation), 2.88 mSv (flat detector CT perfusion with collimation), and 2.17 mSv (multidetector row CT perfusion). A novel protocol called portrait flat detector CT angiography that has a z-axis coverage area comparable with that of multidetector row CT angiography had an estimated effective dose of 0.91 mSv, while the dose from multidetector row CT was 1.35 mSv.

CONCLUSIONS

The estimated effective dose to the patient for flat detector CT perfusion and angiography on a modern biplane angiography system does not deviate substantially from that of analogous multidetector row CT protocols.

摘要

背景与目的

越来越多的急性缺血性脑卒中患者采用一站式管理方法进行分诊,导致基线成像采用平板探测器 CT 扫描仪。本研究旨在评估新型颈椎和颅内平板探测器 CT 血管造影和平板探测器 CT 灌注方案对患者的有效剂量,并与类似多层 CT 方案的有效剂量进行比较。

材料与方法

我们根据国际辐射防护委员会 103 号报告,使用带有金属氧化物半导体场效应晶体管剂量计的人体模型来估算患者的有效剂量。放置位置根据体模制造商提供的器官图确定。我们在体模内使用了 100 个测量点,在体模表面放置了 18 个金属氧化物半导体场效应晶体管剂量计。所有方案均遵循制造商的规格,患者的定位和准直与常规临床实践相同。在具有相同金属氧化物半导体场效应晶体管剂量计放置位置的最新一代血管造影和多层 CT 系统上进行测量。

结果

所研究的灌注方案的估计有效剂量分别为 4.52 mSv(无准直的平板探测器 CT 灌注)、2.88 mSv(有准直的平板探测器 CT 灌注)和 2.17 mSv(多层 CT 灌注)。一种名为 Portrait 平板探测器 CT 血管造影的新型方案具有与多层 CT 血管造影相当的 z 轴覆盖面积,估计有效剂量为 0.91 mSv,而多层 CT 的剂量为 1.35 mSv。

结论

在现代双平面血管造影系统上进行平板探测器 CT 灌注和血管造影的患者估计有效剂量与类似多层 CT 方案的有效剂量没有明显差异。

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