腦部含頸椎電腦斷層掃描最優化之探討

根據聯合國原子輻射效應科學委員會2000年公布的數據，醫用輻射劑量約佔全部人造輻射劑量的98%以上，其中以電腦斷層檢查的貢獻最大。在嚴重多發鈍性挫傷患者全身電腦斷層掃描時常包含對頸椎部位掃描篩檢，本文主旨在探討急重症腦部外傷併有中高度頸椎損傷風險的患者中執行腦部電腦斷層含頸椎掃描協議最僵化為目的。材料與方法，使用奇異公司64切電腦斷層掃描儀，依本實驗設定5種掃描方案，以相關文獻頸部掃描參數條件做比較，探討協議最優化。結果顯示在頸部區使用管電流調控其CTDI_(vol)降低11%，管電壓由120kv降低至100kv其CTDl_(vol)降低了34.2%。確實證明在執行腦部電腦斷層並包含頸椎掃描時，掃描技術、掃描方法決定最適化結果，醫療輻射曝露差異甚大，值得我們省思。如何確定最佳的診斷影像品質和輻射劑量之間的權衡，需要共同的努力。

關鍵字

電腦斷層掃描；自動管電流調控技術；有效劑量

並列摘要

According to the UNSCEAR (United Nations Scientific Committee on the Effects of Atomic Radiation) Report in year 2000, the ninety-eight percent of man-made ionizing radiation exposure to the world population is produced by diagnostic medical X-rays. The increasing use of computed tomography in clinical practice and the relatively high dose delivered to the patient make CT a significant contributor to the population dose from diagnostic medical X-rays. Cervical spine CT is easily included in the whole-body screening performed in patients with severe blunt polytrauma. This study focuses on optimizing the brain including cervical spine CT scan protocol for craniocerebral trauma patients not rule out combined with moderate-to-high risk cervical spine injury. We use GE sixty-four slices MDCT under five different scanning protocol and compare cervical spine CT scanning parameter with other papers to best optimize protocols. We have a eleven percent decrease in CTDl_(vol) with tube current modulation and 34.2 percent decrease when tube voltage is lowered from 120kv to 100kv. In conclusion, the scanning technique and scanning protocol can lead to a huge difference in medical radiation exposure when performing brain including cervical spine CT scans. Therefore, we need great effort on getting the best image qualities with the lowest radiation dosage.

並列關鍵字

computed tomograpby ； automatic tube current modulation ； effective dose

國際替代計量

腦部含頸椎電腦斷層掃描最優化之探討

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