University Medical Centre Ljubljana, Institute of Radiology, Zaloška 7, 1000, Ljubljana, Slovenia; University of Ljubljana, Faculty of Health Sciences, Medical Imaging and Radiotherapy Department, Zdravstvena Pot 5, 1000, Ljubljana, Slovenia.
University College Cork, Discipline of Medical Imaging & Radiation Therapy, Cork, Ireland.
Radiography (Lond). 2023 May;29(3):546-551. doi: 10.1016/j.radi.2023.03.004. Epub 2023 Mar 17.
Pelvic radiography is one of the most frequent general radiography imaging procedures. Pelvic radiography is usually performed in the supine position, but in some cases erect imaging is performed. The aim of this study was to determine whether radiation dose and image quality differ between two different erect pelvic radiographic procedures in overweight and obese patients, with and without displacement of anterior adipose tissue.
This research was a two-part study. The first part of the study was to determine a suitable fat displacement band that would not produce artifacts on the resulting radiograph when fat tissue was displaced. The second part of the study was performed in a clinical setting on 60 overweight or obese patients (BMI ≥25) referred for erect pelvic imaging. Patients were randomly divided into two equal groups, half of which displaced adipose tissue from the region of interest and the other group did not. Waist and hip circumference, height, weight, dose-area- product (DAP), primary field size, source-to-skin distance, mAs, and kV were measured. Body Mass Index (BMI), entrance surface dose (ESD), and effective dose (ED) were then calculated. The resulting images were evaluated by three radiologists.
It was found that a thin cotton triangular bandage produced no visible radiographic artefacts. In the group of patients using the fat displacement protocol, a statistically significant reduction in waist circumference (4.7%), DAP (38.5%), ESD (44%) and ED (38.7%) were observed (p < 0.05). In addition, a significant (p < 0.05) increase was found for all the observed image quality criteria and overall total image score with exception of sacroiliac joint, iliac crest and pubic/ischial rami.
Based on the results, the use of the adipose tissue displacement protocol for radiography of the pelvis and hip in the erect position in overweight and obese patients is recommended.
The use of cotton bands to remove adipose tissue during pelvic imaging in obese and overweight patients results in a reduction of radiation dose received by the patient and improves image quality. This technique is quick, easy, and inexpensive.
骨盆摄影是最常见的普通放射摄影成像程序之一。骨盆摄影通常采用仰卧位进行，但在某些情况下也采用直立成像。本研究的目的是确定在超重和肥胖患者中，在有和没有前脂肪组织移位的情况下，两种不同的直立骨盆放射摄影程序的辐射剂量和图像质量是否存在差异。
本研究分为两部分。第一部分研究旨在确定一种合适的脂肪移位带，当脂肪组织移位时，不会在所得射线照片上产生伪影。第二部分研究在 60 名超重或肥胖患者（BMI≥25）进行，这些患者被转诊进行直立骨盆成像。患者被随机分为两组，每组一半患者将感兴趣区域的脂肪组织移位，另一半患者则不移位。测量腰围和臀围、身高、体重、剂量面积乘积（DAP）、初级射野大小、源皮距、毫安秒和千伏。然后计算体重指数（BMI）、入射表面剂量（ESD）和有效剂量（ED）。由三位放射科医生评估所得图像。
研究发现，薄的棉质三角绷带不会产生可见的射线照相伪影。在使用脂肪移位方案的患者组中，观察到腰围（4.7%）、DAP（38.5%）、ESD（44%）和 ED（38.7%）显著降低（p<0.05）。此外，除了骶髂关节、髂嵴和耻骨/坐骨支外，所有观察到的图像质量标准和总图像评分都显著增加（p<0.05）。
根据研究结果，建议在超重和肥胖患者的直立骨盆和髋部放射摄影中使用脂肪组织移位方案。
在肥胖和超重患者进行骨盆成像时使用棉带去除脂肪组织可降低患者接受的辐射剂量，并提高图像质量。该技术快速、简单且经济实惠。
