腰椎内固定置入物对自动曝光控制技术应用效果的影响

Effect of Lumbar Internal Fixation on the Application of Automatic Exposure Control Technology

[目的]探讨电离室自动曝光控制(Automatic exposure control,AEC)技术在腰椎内固定术后患者腰椎数字X线摄影(Digital radiography,DR)中的应用价值.[方法]收集2019年5~6月在本院西门子DR系统上采用AEC技术拍摄站立位腰椎正位和侧位片的患者262例,查看是否存在金属内固定植入物,并记录图像信息中的管电流量(mAs)和剂量面积乘积(Dose area product,DAP),比较其差异.[结果]纳入站立位腰椎DR中金属内固定植入者56例,无内固定者206例.站立正位片有内固定与无内固定植入者的mAs分别为72±41,59±28,差异有统计学意义(t=2.62,P<0.05),DAP分别为(228±149)μGy·mm2,(181±97)μGy·mm2,差异有统计学意义(t=2.83,P<0.05).站立侧位片有内固定与无内固定植入者的mAs分别为76±38,70±33,差异无统计学意义(t=1.15,P>0.05),DAP分别为264±140,225±122,差异有统计学意义(t=2.09,P<0.05).[结论]腰椎内固定植入术后进行DR随访时,采用AEC技术可能导致不必要的高mAs,增加患者辐射剂量的风险,推荐优先使用经过临床验证和认可的手动摄影曝光参数.

【Objective】To investigate the application value of automatic exposure control(AEC)technology in digital radiography(DR)of lumbar spine after lumbar internal fixation.【Methods】A total of 262 cases of patients with lumbar spine in standing position were collected from May to June in 2019 by using AEC technology in Siemens DR system.The presence of metal internal fixation implants was checked»and the tube electric flow(MAS)and dose area product(DAP)in the image information were recorded,and the differences were compared.【Results】In standing position,56 cases were implanted with metal internal fixation,206 cases were without internal fixation.The mAs of patients with and without internal fixation were 72±41,59±28.The difference was statistically significant(t=2.62,P<0.05),DAP was 228±149,181±97,the difference was statistically significant(t=2.83,P<C0.05).The mAs of patients with and without internal fixation were 76±38,70±33.The difference was not statistically significant(t=1.15,P〉0.05),DAP was 264±140,225±122,the difference was statistically significant(i=2.09,P<0.05).【Conclusion】During DR follow-up after lumbar internal fixation,AEC technology may lead to unnecessary high mAs and increase the risk of radiation dose.It is recommended to give priority to the use of clinically verified and approved manual photographic exposure parameters.