Cinotti A, Benetti S, Boccafogli R, Mannella P
Istituto di Radiologia, Università degli Studi, Ferrara.
Radiol Med. 1994 Oct;88(4):478-82.
The major obstacle to optimal radiographic depiction of the chest has always been its anatomical features and, in particular, the considerable difference in X-ray beam attenuation between pulmonary and mediastinal structures. At least 40% of this region cannot be visualized in an optimal way. Therefore, much technological work was done to overcome this limitation, which has recently led to the development of electronic (Amber) and mechanical (homogenization) filtration systems. This study was aimed at assessing the capabilities of mechanical filtration, in terms of anatomical representation and lower biologic cost, the latter intended as lower exposure and absorbed doses. Therefore, eight radiologists studied 40 negative radiographs, i.e., a homogenized radiograph and a non-homogenized one per patient, twenty patients in all. The statistical analysis of the radiographs demonstrated the homogenized technique to allow better visualization of all the anatomical structures examined, i.e., trachea, carina, right and left main bronchi, aorta, spine and retrocardiac region. In contrast, the two radiographic techniques yielded much the same results in the depiction of the pulmonary pattern. As for dosimetry, good results were also obtained, because the homogenizer made it possible to reduce both exposure and absorbed doses to the lung and thyroid, while in the mediastinal region the absorbed dose remained similar to that measured with the non-homogenized even though exposure dose was increased mildly.
胸部X线最佳成像的主要障碍一直在于其解剖结构,尤其是肺与纵隔结构在X线束衰减方面存在显著差异。该区域至少40%无法以最佳方式显示。因此,人们开展了大量技术工作来克服这一限制,最近已促成电子(琥珀色)和机械(均匀化)过滤系统的研发。本研究旨在评估机械过滤在解剖结构显示及降低生物成本(后者指降低照射剂量和吸收剂量)方面的能力。因此,八位放射科医生研究了40张阴性X光片,即每位患者各有一张均匀化X光片和一张未均匀化X光片,总共20名患者。X光片的统计分析表明,均匀化技术能更好地显示所有检查的解剖结构,即气管、隆突、左右主支气管、主动脉、脊柱和心后区。相比之下,两种X光成像技术在肺纹理显示方面结果大致相同。在剂量测定方面也取得了良好结果,因为均匀化器能够降低肺部和甲状腺的照射剂量和吸收剂量,而在纵隔区域,尽管照射剂量略有增加,但吸收剂量仍与未均匀化时测得的剂量相似。