- 期刊
超低劑量電腦斷層應用在胸部創傷之實證評估與臨床效益
Evidence-based Medicine and Clinical Benefits of Ultra-low-dose Computed Tomography in Chest Trauma
摘要
胸部創傷為意外事故較常見的傷害，本研究期望經由實證醫學的方式、再以假體實驗先行驗證，讓病人得到最有效益的檢查方式。以實證醫學步驟探討可行性，調整檢查參數，使用胸部人形假體進行超低劑量肋骨電腦斷層掃描（TOSHIBA Aquilion 160 multi-slice CT, Japan），經醫師與放射師討論其符合影像品質之超低劑量範圍後，制訂胸部創傷之病人的檢查流程，進而將此超低劑量電腦斷層條件應用於檢查流程中，胸部創傷之病患檢查流程為醫師醫囑開立檢查單（胸部及肋骨X光），但常因病兆微小、病人體型及配合度等原因導致X光影像無法清楚診斷，進而再開立一般胸部電腦斷層檢查，但一般電腦斷層往往需考量劑量的問題，本研究以實證醫學所得出之結果將超低劑量電腦斷層應用在常規檢查上，更動電腦斷層掃瞄儀上所設定之條件，選取對象為2019年7月至2020年6月共128位病人，以BMI ≤ 24（kg / m^2）及BMI ＞ 24做為病人胖瘦區分，BMI ≤ 24所使用條件為100KV，管電流設定為10mAs，BMI ＞ 24之病人管電流則設定為20mAs在不增加病人的檢查項目及輻射劑量之前提下，調整過後的條件即可應用在胸部創傷的病人，即能得到較佳的影像以達正確的診斷及治療並免除效益不佳的檢查。
並列摘要
Chest trauma is a relatively common injury in accidents. This study hopes to use Evidence-based medicine and prosthesis experiments to verify it in advance, so that patients can get the most effective examination method. Empirical medical procedures were used to explore the feasibility, adjust the parameters, and use the thoracic humanoid prosthesis to perform ultra-low-dose rib computer tomography (TOSHIBA Aquilion 160 multi-slice CT, Japan). The doctor and radiologist discussed the ultra-low image quality After the dose range, the examination procedure for patients with chest trauma is formulated, and then this ultra-low-dose computerized tomography condition is applied to the examination procedure. The examination procedure for patients with thoracic trauma is an examination sheet (one chest x-ray and ribs Several x-rays), but often due to small symptoms, patient size and coordination, the x-ray image cannot be clearly diagnosed, and then a normal chest computer tomography is performed. However, traditional computer tomography often has the problem of excessive dose. The results obtained apply ultra-low-dose computed tomography in routine examinations, change the conditions set on the computed tomography scanner, and select 128 patients from July 2019 to June 2020 with a BMI ≤ 24 and BMI＞ 24 to distinguish between fat and thin patients. The use condition for BMI ≤ 24 is 100KV, the tube current is set to 10mAs, and the tube current for patients with BMI＞ 24 is set to 20mAs without increasing the patient's inspection items and radiation dose As mentioned before, the adjusted conditions can be applied to patients with chest trauma, that is, better images can be obtained to achieve correct diagnosis and treatment and to avoid poorly effective examinations.