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在临床实践中对脑部 CT 检查的眼部晶状体辐射剂量 - 为优化机架倾斜度和扫描长度而对放射技师进行培训的效果。

RADIATION DOSE OF THE EYE LENS IN CT EXAMINATIONS OF THE BRAIN IN CLINICAL PRACTICE-THE EFFECT OF RADIOGRAPHER TRAINING TO OPTIMISE GANTRY TILT AND SCAN LENGTH.

机构信息

Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.

Department of Medical Physics, Medical Imaging Center, Pirkanmaa Hospital District, Tampere, Finland.

出版信息

Radiat Prot Dosimetry. 2023 Apr 5;199(5):391-398. doi: 10.1093/rpd/ncad002.

Abstract

Lenses are always exposed to radiation in brain computed tomography (CT) scans. However, the lens dose can be reduced by excluding lens from scanning area by optimising gantry tilt and scan length. The object of this study is to retrospectively analyse if the optimisation by gantry tilt and scan length have been adequate in the CT scan of the brain, and to prospectively analyse the effect of radiographer training to the quality of the CT examinations. This study was conducted in two parts. In all, 329 brain CTs performed in the Tampere University Hospital from 2017 to 2019 were revised retrospectively. The prospective part included 51 brain CT studies conducted in October 2021. Dose to the eye of the lens was modelled using CT-Expo using zero-degree beam angle and scan lengths to expose the lens either to the primary or scattered radiation. Non-zero gantry tilt had been used in a large proportion of the CT examinations in the retrospective setting, 84.8%. However, the lenses were successfully excluded from the scan area in only 1.8% of the examinations. In the prospective part, the gantry tilt was used in 98% of the studies and the proportion of successful examinations rose from 1.8 to 11.8%. The lens dose decreased significantly when the eyes were excluded from the imaging area. The modelled lens dose in the large retrospective part was 25.9 mGy (17.8-49.2 mGy) when the eyes were included and 1.5 mGy (0.4-1.9 mGy) when the eyes were excluded. The lens dose was similar in the small prospective part. Despite the gantry tilt is widely used, unnecessary lens irradiation occurs extensively because of suboptimal gantry tilt and scan length. The training of radiographers reduces the radiation exposure to the lens by more optimal gantry tilt and scan length.

摘要

晶状体在脑部计算机断层扫描(CT)中始终会受到辐射。然而,通过优化机架倾斜度和扫描长度,可以将晶状体排除在扫描区域之外,从而降低晶状体剂量。本研究的目的是回顾性分析在脑部 CT 扫描中,通过机架倾斜度和扫描长度的优化是否充分,以及前瞻性分析放射技师培训对 CT 检查质量的影响。本研究分为两部分。总共回顾性分析了 2017 年至 2019 年在坦佩雷大学医院进行的 329 例脑部 CT 检查。前瞻性部分包括 2021 年 10 月进行的 51 例脑部 CT 研究。使用 CT-Expo 模型,在零度束角和暴露晶状体于初级或散射辐射的扫描长度下,对晶状体的眼部剂量进行建模。在回顾性研究中,84.8%的 CT 检查使用了非零机架倾斜度,但只有 1.8%的检查成功将晶状体排除在扫描区域之外。在前瞻性部分,98%的研究使用了机架倾斜度,成功检查的比例从 1.8%上升到 11.8%。当将眼睛排除在成像区域之外时,晶状体剂量显著降低。在大型回顾性部分中,当眼睛被包括时,模型化的晶状体剂量为 25.9 mGy(17.8-49.2 mGy),当眼睛被排除时,晶状体剂量为 1.5 mGy(0.4-1.9 mGy)。在小型前瞻性部分中,晶状体剂量相似。尽管机架倾斜度广泛使用,但由于机架倾斜度和扫描长度不理想,晶状体仍会受到不必要的辐射。放射技师的培训通过更优化的机架倾斜度和扫描长度来减少晶状体的辐射暴露。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7164/10077499/3a3e08e6e3b8/ncad002f1.jpg

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