HUS Diagnostic Center, Radiology, University of Helsinki and Helsinki University Hospital, P.O. Box 340, 00290, Helsinki, Finland.
Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, Päijät-Häme Joint Authority for Health and Wellbeing, Lahti, Finland.
Pediatr Radiol. 2023 Jul;53(8):1704-1712. doi: 10.1007/s00247-023-05644-3. Epub 2023 Mar 27.
When postoperative multi-slice computed tomography (MSCT) imaging of patients with craniosynostosis is used, it is usually performed a few days after surgery in a radiology department. This requires additional anesthesia for the patient. Recently, intraoperative mobile cone-beam CT (CBCT) devices have gained popularity for orthopedic and neurosurgical procedures, which allows postoperative CT imaging in the operating room.
This single-center retrospective study compared radiation dose and image quality of postoperative imaging performed using conventional MSCT scanners and O-arm CBCT.
A total of 104 pediatric syndromic and non-syndromic patients who were operated on because of single- or multiple-suture craniosynostosis were included in this study. The mean volumetric CT dose index (CTDI) and dose-length product (DLP) values of optimized craniosynostosis CT examinations (58 MSCT and 46 CBCT) were compared. Two surgeons evaluated the subjective image quality.
CBCT resulted in significantly lower CTDI (up to 14%) and DLP (up to 33%) compared to MSCT. Multi-slice CT image quality was considered superior to CBCT scans. However, all scans were considered to be of sufficient quality for diagnosis.
The O-arm device allowed for an immediate postoperative CBCT examination in the operating theater using the same anesthesia induction. Radiation exposure was lower in CBCT compared to MSCT scans, thus further encouraging the use of O-arms. Cone-beam CT imaging with an O-arm is a feasible method for postoperative craniosynostosis imaging, yielding less anesthesia to patients, lower health costs and the possibility to immediately evaluate results of the surgical operation.
当对颅缝早闭患者进行术后多层计算机断层扫描（MSCT）成像时，通常在放射科进行，这需要对患者进行额外的麻醉。最近，术中移动锥形束 CT（CBCT）设备在矫形和神经外科手术中越来越受欢迎，允许在手术室进行术后 CT 成像。
本单中心回顾性研究比较了使用传统 MSCT 扫描仪和 O 臂 CBCT 进行术后成像的辐射剂量和图像质量。
共纳入 104 例因单一或多发颅缝早闭而接受手术的小儿综合征和非综合征患者。比较了优化的颅缝早闭 CT 检查（58 次 MSCT 和 46 次 CBCT）的平均容积 CT 剂量指数（CTDI）和剂量长度乘积（DLP）值。两位外科医生评估了主观图像质量。
与 MSCT 相比，CBCT 导致 CTDI（高达 14%）和 DLP（高达 33%）显著降低。多排 CT 图像质量被认为优于 CBCT 扫描。然而，所有的扫描都被认为具有足够的诊断质量。
O 臂设备允许在同一麻醉诱导下在手术室进行立即术后 CBCT 检查。与 MSCT 扫描相比，CBCT 的辐射暴露量较低，因此进一步鼓励使用 O 臂。O 臂锥形束 CT 成像术是一种可行的术后颅缝早闭成像方法，可为患者提供较少的麻醉、降低健康成本，并可立即评估手术效果。
