Radiation Dose Reduction for Barium Enema: an Achievable Improvement in Patient Care
BMH Lai, VKP Fung, JSF Shum, ANL Sy, SCS Cheng, JLS Khoo
Hong Kong J Radiol 2011;14:212-7
Objective: To evaluate the effectiveness and practicality of dose-reduction measures for double-contrast barium enema based on well-established UK National Reference Levels.
Methods: Between May 2009 and February 2011, 369 patients were prospectively studied with respect to radiation doses received while undergoing double-contrast barium enema examinations before and after implementation of radiation dose-reduction measures. Statistical analysis was performed on fluoroscopic screening times, dose-area-product, and the number of undercouch and overcouch films used during the examination.
Results: A significant reduction in fluoroscopic screening time (43%) was achieved after implementation of dose-reduction measures (p < 0.01). Similarly, a 40% reduction in dose-area-product was achieved at the end of the study (p < 0.01). Before the implementation of the dose-reduction measures, the mean dose-area-product and fluoroscopic screening time at our centre were at 73% and 58% above the UK National Reference Levels, respectively. At the end of the study, they were noted to be up to 13% lower than the UK standards.
Conclusion: A 40% reduction in radiation dose on patients undergoing double-contrast barium enema was achieved after implementation of dose-reduction measures in our hospital. The double-contrast barium enema radiation dose was also reduced from 73% above the UK National Reference Level to a level below this reference standard.
中文摘要
鋇劑灌腸攝影中降低放射劑量：病人照料方面的改進
賴銘曦、馮邦、岑承輝、施雅倫、鄭志成、邱麗珊
目的：按英國國家參考水平建議來評估在雙重對比鋇劑灌腸攝影中把放射劑量降低的措施的效用及 實用性。
方法：本前瞻性研究的對象是於2009年5月至2011年2月期間，369名接受雙重對比鋇劑灌腸檢查的病 人。找出他們在放射劑量降低措施實行前和後所接受放射劑量水平的情況。用統計分析方法研究病 人的熒光屏照射時間、劑量面積乘積、及檢查過程中使用檢查床下膠片和檢查床上膠片的數量。
結果：實行降低放射劑量的措施後，熒光屏照射時間顯著減少43%（p < 0.01），而劑量面積乘積亦 同樣下降40%（p < 0.01）。實行措施前，本中心的平均劑量面積乘積和熒光屏照射時間比英國國家 參考水平建議的分別高出73%和58%。接近研究尾聲時，兩項數據都比建議的水平減低了13%。
結論：實行降低放射劑量措施後，接受雙重對比鋇劑灌腸檢查的病人接受放射劑量減少了40%。而 放射劑量的水平，亦由措施前高出英國國家參考水平73%回落至參考水平以下。