| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 8.26 MB | Adobe PDF |
Advisor(s)
Abstract(s)
O número de exames de tomografia computorizada realizados por ano em crianças apresenta crescimento contínuo e por conseguinte a crescente preocupação com os potenciais efeitos indesejados da radiação ionizante. Especialmente nesta população, exige a otimização dos protocolos de exames, reduzindo a exposição. A otimização de protocolos de neurorradiologia pediátrica, é relevante na proteção radiológica, na adoção de boas práticas, na segurança do paciente onde é visado uma redução efetiva de dose, mantendo a qualidade de imagem de diagnóstico. Pretende-se com este estudo avaliar as doses praticadas em neurorradiologia pediátrica num equipamento multidetetor e medir e comparar a dose administrada com a alteração de protocolos do ano 2012 para o ano 2013 num hospital Pediátrico. Apresentam-se como objetivos específicos: 1. Determinar os valores de CTDIvol e DLP para os exames de neurorradiologia em pediatria;
2. Avaliar se houve redução de dose e verificar os NRD de acordo com a guidelines internacionais; 3. Refletir sobre as práticas radiológicas e estratégias de redução de dose aplicadas sem comprometer o diagnóstico clínico. A estratégica metodológica adotada foi de um estudo de caso do tipo descritivo, exploratório e comparativo tendo o estudo de caso como base de trabalho, para maior aprofundamento da particularidade, o serviço de Radiologia do Hospital de D. Estefânia. Recorreu-se a testes descritivos e inferência estatística. A partir dos resultados deste estudo concluímos que existiu uma diminuição do valor médio do CTDIvol correspondendo a um decréscimo de 5,7 mGy na dose de radiação emitida ao doente em todos os exames efetuados e em ambos os géneros no ano de 2013 em relação a 2012. Foi demostrado que 95% dos casos sofreram uma redução de 16 mGy no CTDIvol em 2013 em relação a 2012 e que essas diferenças encontradas têm significância estatística. Para o DLP os valores médios variaram entre os anos de 2012 e 2013 com uma diferença nominal de 50,9 mGy.cm logo, com uma diferença média estatisticamente significativa, houve um menor volume irradiado e como tal uma redução de dose recebida pelo doente. Nos percentis P5 e P10 os valores de DLP são superiores no ano de 2013 mas para o percentil 75, P75= (Q3), existe uma diferença de 40 mGy.cm a menos no ano de 2013 em relação a 2012. Uma das maiores conclusões deste estudo foi a promoção dum trabalho de equipa fortemente marcado pela cooperação e responsabilização tal como indicam os programas da Qualidade e Controlo da Qualidade em Radiologia.
ABSTRACT - The number of CT scanners performed per year in children shows continuous growth and therefore this growing concern about the potential undesirable effects of ionizing radiation. Especially in this population, is required an optimization of the protocols, regarding the reducing of exposure. The optimization of pediatric neuroradiology protocols is relevant in radiological protection, in the adoption of good practices, inpatient safety where an effective dose reduction is aimed, maintaining the diagnostic image quality. The aim of this study was to evaluate the doses of pediatric neuroradiology in multidetector equipment and to measure and compare the dose emitted with the change of protocols from the year 2012 to 2013 in a Paediatric Hospital. Specific objectives are 1. Determine the values of CTDIvol and DLP for pediatric neuroradiology exams; 2. Evaluate if there was a dose reduction and verify NRD according to international guidelines; 3. Reflect on radiological practices and dose reduction strategies applied without impairing clinical diagnosis. The methodological strategy adopted was a descriptive, exploratory, and comparative study, having the case study as a basis for further results of the particularity of the Radiology Department from D. Estefânia Hospital. The descriptive tests and statistical inference were applied. From the results of this study, we concluded that there was a decrease in the mean value of the CTDIvol corresponding to a decrease of 5.7 mGy in the dose of radiation emitted to the patient in all exams performed and in both genders in the year 2013 related to 2012. It was demonstrated that in 95% of the subjects were verified a reduction of 16 mGy in the CTDIvol in 2013 compared to 2012 and that these differences found are statistically significant. For DLP, mean values ranged between 2012 and 2013 reach a nominal difference of 50,9 mGy.cm so, with a statistically significant mean difference, there was a smaller irradiated volume and as such a reduction of the dose received by the patient. In the P5 and P10 percentiles the DLP values are higher in 2013 but for the 75th percentile, P75 = (Q3), there is a difference of 40 mGy.cm less in the year 2013 compared to 2012. One of the major conclusions of this study was the promotion of teamwork marked by cooperation and accountability as indicated by the Quality and Quality Control programs in Radiology.
ABSTRACT - The number of CT scanners performed per year in children shows continuous growth and therefore this growing concern about the potential undesirable effects of ionizing radiation. Especially in this population, is required an optimization of the protocols, regarding the reducing of exposure. The optimization of pediatric neuroradiology protocols is relevant in radiological protection, in the adoption of good practices, inpatient safety where an effective dose reduction is aimed, maintaining the diagnostic image quality. The aim of this study was to evaluate the doses of pediatric neuroradiology in multidetector equipment and to measure and compare the dose emitted with the change of protocols from the year 2012 to 2013 in a Paediatric Hospital. Specific objectives are 1. Determine the values of CTDIvol and DLP for pediatric neuroradiology exams; 2. Evaluate if there was a dose reduction and verify NRD according to international guidelines; 3. Reflect on radiological practices and dose reduction strategies applied without impairing clinical diagnosis. The methodological strategy adopted was a descriptive, exploratory, and comparative study, having the case study as a basis for further results of the particularity of the Radiology Department from D. Estefânia Hospital. The descriptive tests and statistical inference were applied. From the results of this study, we concluded that there was a decrease in the mean value of the CTDIvol corresponding to a decrease of 5.7 mGy in the dose of radiation emitted to the patient in all exams performed and in both genders in the year 2013 related to 2012. It was demonstrated that in 95% of the subjects were verified a reduction of 16 mGy in the CTDIvol in 2013 compared to 2012 and that these differences found are statistically significant. For DLP, mean values ranged between 2012 and 2013 reach a nominal difference of 50,9 mGy.cm so, with a statistically significant mean difference, there was a smaller irradiated volume and as such a reduction of the dose received by the patient. In the P5 and P10 percentiles the DLP values are higher in 2013 but for the 75th percentile, P75 = (Q3), there is a difference of 40 mGy.cm less in the year 2013 compared to 2012. One of the major conclusions of this study was the promotion of teamwork marked by cooperation and accountability as indicated by the Quality and Quality Control programs in Radiology.
Description
Keywords
Radiologia Tomografia computorizada Níveis de referência Diagnóstico Otimização de protocolos Neurorradiologia pediátrica Descritores de dose em TC Radiology Computed tomography Reference levels Diagnostic Optimization protocols Pediatric neuroradiology Descriptors dose in CT Portugal Hospital D. Estefânia
Citation
Batalha FI. Otimização dos protocolos de estudo em tomografia computorizada aplicados à neurorradiologia pediátrica: estudo de caso no CHLC [thesis]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; 2017.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa