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Digital Subtraction Myelography is Associated with Less Radiation Dose than CT-based Techniques.
Clinical Neuroradiology ( IF 2.8 ) Pub Date : 2020-08-17 , DOI: 10.1007/s00062-020-00942-x
Patrick J Nicholson 1 , William C Guest 1 , Monique van Prooijen 2 , Richard I Farb 1
Affiliation  

Purpose

Both CT myelogram (CTM) and digital-subtraction myelogram (DSM) can be used to evaluate patients for possible cerebrospinal fluid (CSF) leaks. DSM is a relatively new technique. No data exists on the radiation dose associated with this procedure, and how it compares with CTM.

Materials and Methods

All patients who underwent DSM for spontaneous intracranial hypotension (SIH) refractory to blood patching from Dec 2016 – Sept 2019 were retrospectively assessed. DSM dose factors were then recorded (cumulative fluoroscopy time, total kerma area product (KAP, mGy.cm2), cumulative air kerma (mGy), as well as CTM dose factors (included CTDIvol (mGy) and dose-length product (DLP, mGy.cm). These indices were then used to calculate the effective dose for both procedures using standardized conversion factors.

Results

61 DSMs were performed in 42 patients, 33 of which also underwent CTM. The median effective dose was 6.6 mSv per DSM study (range: 1.2 – 17.7). On a per-patient basis (i.e. those patients who underwent more than one DSM (as the initial one was negative), the median total effective dose was 13 mSv for their total DSM imaging (range: 2.6 –31.7). For the CTM, the median effective dose was 19.7 mSv (range: 3.2 – 82.4 mSv).

Conclusion

The radiation dose with DSM appears to be significantly lower than that of CTM (p = 0.0005), when looking at CTM doses both from our institution and in the published literature.



中文翻译:

与基于 CT 的技术相比,数字减影脊髓造影与更少的辐射剂量相关。

目的

CT 脊髓造影 (CTM) 和数字减影脊髓造影 (DSM) 均可用于评估患者可能存在的脑脊液 (CSF) 泄漏。DSM 是一种相对较新的技术。没有关于与此程序相关的辐射剂量的数据,以及它与 CTM 的比较。

材料和方法

从 2016 年 12 月至 2019 年 9 月,所有因自发性颅内低血压 (SIH) 对血液修补无效而接受 DSM 的患者进行了回顾性评估。然后记录 DSM 剂量因子(累积透视时间、总比释动能面积乘积(KAP、mGy.cm2)、累积空气比释动能(mGy)以及 CTM 剂量因子(包括 CTDIvol (mGy) 和剂量长度乘积 (DLP, mGy.cm). 然后使用这些指数来计算使用标准化转换因子的两种程序的有效剂量。

结果

42 名患者进行了 61 次 DSM,其中 33 名也接受了 CTM。每项 DSM 研究的中位有效剂量为 6.6 mSv(范围:1.2 – 17.7)。在每位患者的基础上(即那些接受了不止一次 DSM 的患者(因为最初的一次为阴性),其总 DSM 成像的中位总有效剂量为 13 毫希(范围:2.6 – 31.7)。对于 CTM,中位有效剂量为 19.7 mSv(范围:3.2 – 82.4 mSv)。

结论

从我们机构和已发表的文献中查看 CTM 剂量时,DSM 的辐射剂量似乎显着低于 CTM(p = 0.0005)。

更新日期:2020-08-17
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