Bin Owien Ali, Alenazi Khaled, Abanomy Ahmad, Almanaa Mansour, Alarifi Mohammad, Alahmad Haitham
Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia.
Department of Radiology, King Faisal Specialist Hospital and Research Center, P.O. Box. 3354, Riyadh 12713, Saudi Arabia.
Medicina (Kaunas). 2024 Nov 26;60(12):1952. doi: 10.3390/medicina60121952.
: Computed tomography of the kidneys, ureters, and bladder (CT KUB) is essential for evaluating urinary stones but also exposes patients to significant radiation. The scanning field should be minimized to only the necessary area to limit this radiation exposure. This study aims to assess the extent of CT KUB overscanning in renal colic procedures and identify the appropriate vertebral level for starting CT KUB scans. : A retrospective analysis of 299 adult patients who underwent CT KUB examinations for kidney stone assessment was performed. To assess overscanning, the number of excess slices above the pole of the highest kidney and under the pubic symphysis was measured on the axial image of each patient. To allow for potential human error, a maximum acceptable level of overscanning was set at 10%. : This study found that only 31% of the scans met the target of less than 10% of overscanning superior to the highest kidney and inferior to the pubic symphysis. In comparison, overscanning was present in 69% of the scans, mainly at a superior level, resulting in higher radiation exposure for patients. : A significant number of the scans exhibited unnecessary overscanning beyond the highest kidney, prompting us to propose using the upper border of the T10 vertebral body as a potential reference point to establish the upper margin for a CT KUB scan. This study suggests using T10 and the pubic symphysis as reliable landmarks to accurately determine the scan length. Starting CT KUB scans from the T10 vertebral body to the pubic symphysis allows for imaging of the entire urinary tract, minimizing unnecessary overscanning and reducing patient irradiation.
肾脏、输尿管和膀胱的计算机断层扫描(CT KUB)对于评估尿路结石至关重要,但也会使患者暴露于大量辐射中。扫描视野应仅缩小至必要区域,以限制这种辐射暴露。本研究旨在评估肾绞痛检查中CT KUB过度扫描的程度,并确定开始CT KUB扫描的合适椎体水平。
对299例接受CT KUB检查以评估肾结石的成年患者进行了回顾性分析。为了评估过度扫描情况,在每位患者的轴向图像上测量高于最高肾脏极点和低于耻骨联合的多余切片数量。为了考虑潜在的人为误差,将最大可接受的过度扫描水平设定为10%。
本研究发现,只有31%的扫描符合高于最高肾脏和低于耻骨联合的过度扫描低于10% 的目标。相比之下,69%的扫描存在过度扫描,主要是在较高水平,导致患者接受更高的辐射暴露。
大量扫描显示在最高肾脏上方存在不必要的过度扫描,促使我们建议使用T10椎体上缘作为确定CT KUB扫描上缘的潜在参考点。本研究建议使用T10和耻骨联合作为可靠的标志来准确确定扫描长度。从T10椎体到耻骨联合开始进行CT KUB扫描可以对整个尿路进行成像,最大限度地减少不必要的过度扫描并减少患者的辐射。