Emergency CT head and neck imaging: effects of swimmer’s position on dose and image quality

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• 作者：Fabian G. Mueck (1)
  Sebastian Roesch (1)
  Lucas Geyer (1)
  Michael Scherr (1)
  Michael Seidenbusch (1)
  Robert Stahl (1)
  Zsuzsanna Deak (1)
  Stefan Wirth (1)
  
• 关键词：CT ; Trauma ; Spine ; Patient positioning ; Personalized medicine
• 刊名：European Radiology
• 出版年：2014
• 出版时间：May 2014
• 年：2014
• 卷：24
• 期：5
• 页码：969-979
• 全文大小：759 KB
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• 作者单位：Fabian G. Mueck (1)
  Sebastian Roesch (1)
  Lucas Geyer (1)
  Michael Scherr (1)
  Michael Seidenbusch (1)
  Robert Stahl (1)
  Zsuzsanna Deak (1)
  Stefan Wirth (1)
  
  1. Institut für Klinische Radiologie, LMU Klinikum der Universit?t München - Innenstadt, Department of Clinical Radiology, LMU Hospital of the University of Munich - Downtown Campus, Nu?baumstr. 20, 80336, Munich, Germany
  
• ISSN：1432-1084

文摘

Objectives To compare the effects of different arm positions on dose exposure and image quality (IQ) in cervical spine CT after trauma in different patient groups. Methods Patients in standard (STD--26) and in swimmer’s position (SWIM--54) were included. Body mass index (BMI subgroup?1-?underweight to subgroup?4-?obese), anterior–posterior diameter (AP), left–right diameter (LR), area of an ellipse (AoE) and angle between the humeral heads (optimal?STD-lt;-°, optimal?SWIM-gt;-0°) were used as grouping criteria. Computed tomography dose index (CTDI) was documented. Two radiologists rated the IQ at three levels (CV1/2, CV4/5, CV7/T1) using a semi-quantitative scale (0-?not?diagnostic, 1-?diagnostic?with?limitations, 2-?diagnostic?without?limitations). The Mann–Whitney U test correlations of grouping criteria with dose effects and intra-class correlation (ICC) were calculated. Results ICC was 0.87. BMI grouping showed the strongest correlation with dose effects: CTDI of optimal?STD versus optimal?SWIM positioning was 3.17?mGy versus 2.46?mGy (subgroup?1), 5.47?mGy versus 3.97?mGy (subgroup?2), 7.35?mGy versus 5.96?mGy (subgroup?3) and 8.71?mGy versus 8.18?mGy (subgroup?4). Mean IQ at CV7/T1 was 1.65 versus 1.23 (subgroup?1), 1.27 versus 1.46 (subgroup 2), 1.06 versus 1.46 (subgroup 3), 0.79 versus 1.5 (subgroup 4). Conclusion Patients with a BMI-gt;-0?kg/m2 benefited from both potential dose reduction and improved image quality at the critical cervicothoracic junction when swimmer’s position was used. Key Points -BMI is a useful metric for personalized optimization in CT for the c-spine. -Using swimmer’s position, patients can benefit from dose reduction. -In some patients a superior image quality can be achieved with swimmer’s position. -For swimmer’s positioning an angle of more than 10° is optimal.