Pietzka Sebastian, Grieser Anne, Winter Karsten, Schramm Alexander, Metzger Marc, Semper-Hogg Wiebke, Grunert Michael, Ebeling Marcel, Sakkas Andreas, Wilde Frank
Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Ulm, Germany.
Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Ulm, Germany.
Craniomaxillofac Trauma Reconstr. 2024 Dec;17(4):270-278. doi: 10.1177/19433875231213906. Epub 2023 Nov 10.
STUDY DESIGN: Experimental single-centre study of X-ray absorption using a phantom skull. OBJECTIVE: This experimental study aimed to compare the radiation doses of different 3D imaging devices used in maxillofacial surgery, including one Multidetector CT (MDCT), two Conebeam CT (CBCT) and four intraoperative 3D C-arms. METHODS: Thermoluminescent dosimeters (TLD) were used to determine the absorbed radiation in an Alderson-Rando phantom skull. The phantom skull was positioned in the before mentioned seven devices and a defined 3D facial skull image was acquired. Subsequently, the TLD'S were read out and the effective doses (ED) and the organ doses (OD) were calculated and compared. RESULTS: OD varied significantly between tissues as well as between the 3D X-ray devices. The OD of the 3D C-arms were significantly lower than those of all other devices. The OD of the CT, especially in the standard setting, was the highest. Only by special adjustments of the scan protocol regarding CMF requirements for traumatology, the MDCT could achieve almost equivalent doses as the two tested CBCT-scanners. The calculated effective doses were also lowest for the 3D C-arm devices (11.2 to 129.9 μSv). The ED of the MDCT were significant higher (284.52-844.97 μSv) than in all other devices. The ED of the CBCTs (173.7-184.9) were lower than for MDCT but still higher than those of the 3D C-arms. CONCLUSIONS: Intraoperative imaging using 3D C-arm devices is an effective method to verify reduction results in maxillofacial surgery intraoperatively with significantly lower ED than postoperatively CBCT and MDCT imaging.
研究设计:使用仿真颅骨进行X射线吸收的单中心实验研究。 目的:本实验研究旨在比较颌面外科中使用的不同3D成像设备的辐射剂量,包括一台多排螺旋CT(MDCT)、两台锥形束CT(CBCT)和四台术中3D C形臂。 方法:使用热释光剂量计(TLD)测定Alderson-Rando仿真颅骨中的吸收辐射。将仿真颅骨放置在上述七种设备中,并获取定义的3D面部颅骨图像。随后,读出TLD并计算和比较有效剂量(ED)和器官剂量(OD)。 结果:OD在组织之间以及3D X射线设备之间存在显著差异。3D C形臂的OD显著低于所有其他设备。CT的OD最高,尤其是在标准设置下。只有通过根据创伤学的CMF要求对扫描协议进行特殊调整,MDCT才能达到与两台测试的CBCT扫描仪几乎相同的剂量。计算得出的有效剂量在3D C形臂设备中也是最低的(11.2至129.9μSv)。MDCT的ED显著高于所有其他设备(284.52 - 844.97μSv)。CBCT的ED(173.7 - 184.9)低于MDCT,但仍高于3D C形臂。 结论:在颌面外科手术中,使用3D C形臂设备进行术中成像,是一种有效验证复位结果的方法,其有效剂量明显低于术后CBCT和MDCT成像。
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