RESUMEN
AIM: To evaluate the effect of modification of dose mode and frame rate on patient radiation dose during modified barium swallow (MBS) examinations. MATERIALS AND METHODS: A retrospective review was undertaken of consecutive MBS examinations performed over 6 months in the inpatient setting. Patients were divided into two cohorts: pre-implementation of the MBS Impairment Profile (MBSImP; low rate, normal dose) and post-implementation (high rate, low dose). Prior to implementation, pulse rate and dose testing were performed on multiple phantoms. RESULTS: Four hundred and forty-nine patients were included in the pre-implementation cohort and 378 in the post-implementation cohort. Phantom dose testing demonstrated no significant difference in dose on either phantom between low rate/normal dose and high rate/low dose modes. Prior to MBS standardisation, the mean radiation dose was 5.86 (±4.35) mGy. Following standardisation, the mean radiation dose was 4.72 (±3.77) mGy (p<0.0001). The mean fluoroscopy time for MBS prior to standardisation was 83.8 (±44.4) seconds and the mean fluoroscopy time for MBS after standardisation was 82.3 (±39.8) seconds (p=0.62). The dose rate for MBS prior to standardisation was 4.35 (±2.42) and the dose rate for MBS after standardisation was 3.55 (±2.41) mGy/s (p<0.0001). CONCLUSION: Adjustments made to lower the dose mode and the increase in fluoroscopy frame rate decreased the patient radiation dose and did not increase fluoroscopy time.
Asunto(s)
Sulfato de Bario/administración & dosificación , Medios de Contraste/administración & dosificación , Trastornos de Deglución/diagnóstico por imagen , Dosis de Radiación , Administración Oral , Adulto , Femenino , Fluoroscopía , Frecuencia Cardíaca , Humanos , Masculino , Fantasmas de Imagen , Estudios Retrospectivos , Factores de TiempoRESUMEN
A formalism is presented that concisely describes the magnetization of a sample subjected to a periodic series of RF pulses. In this formalism, the steady state of the magnetization is shown to be a sum of magnetic substates, each with unique contrast characteristics. When more than one substate contributes to a given image, the substates interfere with each other, producing ghosts and other artifacts. Properly designed gradient protocols can image single substates, producing ghost-free images. The contrast of the image depends largely on the choice of the imaged substate. Analytic solutions for unspoiled, RF spoiled, and gradient spoiled magnetizations are presented.
Asunto(s)
Imagen por Resonancia Magnética/métodos , Artefactos , Humanos , Procesamiento de Imagen Asistido por Computador , Fantasmas de Imagen , Procesamiento de Señales Asistido por ComputadorRESUMEN
The effect of x-ray tube potential and prepatient and interdetector filtration in single exposure dual energy chest imaging has been studied employing a carefully benchmarked model. The analysis utilized published methodology. Noise in simulated lung and mediastinum fields of the aluminum (bone) and Lucite (soft tissue) images were studied at fixed entrance skin exposure (ESE) for commonly employed sandwich detector and sandwich imaging plate configurations. Our results indicate noise in the lung increases slowly with tube potential above 120 kVp, while noise in the mediastinum decreases rapidly. Also, at high tube potential (> or = 120 kVp) adding moderate amounts of prepatient K-edge filtration (approximately equal to 100 mg/cm2) while optimizing imaging conditions for the lung tends to decrease noise in the lungs by approximately equal to 30% while increasing noise in the mediastinum by a similar amount. Without K-edge prepatient filtration, noise in the lung is minimized with Cu interdetector filter weights near 400 mg/cm2. In the mediastinum noise is minimized with heavier interdetector filter and prepatient K-edge filter weights. Prepatient K-edge filter weights that minimize image noise in either field can increase the tube loading by factors ranging from 10 to 10(10). Systems designed with sandwich detectors using commercially available phosphors and coating weights can produce contrast-to-noise ratios (CNRs) as high as 50% of the theoretical limit (defined as an optimized system with a totally absorbing rear detector).