Hoʻomaopopo i ka hoʻohana ʻana o CT scans i ka radiation
Ma kona kumu, a Hana ʻia ʻo CT Scanner ma ka hoʻohui ʻana i ka ʻenehana X-ray me ka hoʻoili kamepiula paʻakikī. ʻAʻole like me ka X-ray maʻamau e kiʻi i hoʻokahi kiʻi palahalaha, hoʻololi ka CT Scanner i kahi paipu X-ray a me nā mea ʻike a puni ka mea maʻi, e loaʻa ana i nā kiʻi keʻa he nui (' nā ʻāpana ') mai nā kihi like ʻole. A laila, kūkulu hou ʻia kēia mau ʻāpana e nā kamepiula ikaika i nā kiʻi 2D a me 3D kikoʻī loa o nā iwi, nā kīʻaha koko, nā ʻiʻo palupalu, a me nā kino. Loaʻa ka ikehu o ka radiation ionizing i hoʻohana ʻia e ka CT Scanner e hele i loko o ke kino a hana i kēia mau kiʻi, akā lawe pū ia i ka hiki ke launa pū me ka DNA cellular.
Ana ʻia ka nui o ka radiation i hāʻawi ʻia e kahi CT Scanner ma millisieverts (mSv). He ʻokoʻa ka nui o ka nui ma muli o ka ʻāpana kino i nānā ʻia a me ka protocol kikoʻī i hoʻohana ʻia:
Head CT: 1-2 mSv maʻamau
ʻO ka umauma CT: 5-7 mSv maʻamau
ʻĀpana/Pelvis CT: ʻO 7-10 mSv maʻamau
Coronary CT Angiography: Hiki ke loaʻa mai ka 3-15 mSv ma muli o ka protocol a me ka ʻenehana
No ka hoʻomaopopo ʻana i kēia, loaʻa i ka awelika kanaka ma ʻAmelika Hui Pū ʻIa ma kahi o 3 mSv i kēlā me kēia makahiki mai nā kumu hoʻoheheʻe kūlohelohe kūlohelohe e like me radon, cosmic rays, a me nā minela i loko o ka lepo. ʻO kahi kaʻina hana CT Scanner ʻōpū hoʻokahi, no laila, hāʻawi i kahi maʻa e like me nā makahiki he nui o ka ʻike kūlohelohe kūlohelohe. ʻOiai ʻo ka pilikia e pili ana me kahi diagnostic CT Scanner scan i manaʻo ʻia he haʻahaʻa loa no nā pākeke, ʻoiai inā pono ke olakino, ʻo ke kumu o ka ALARA (As Low As Reasonably Achievable) ka mea nui. Ke alakaʻi nei kēia kumumanaʻo i kēlā me kēia ʻano o ka pale ʻana i ka radiation ma nā keʻena CT Scanner, e hōʻoia ana e hoʻemi mau ʻia ka nui o ka radiation me ka ʻole e hoʻololi i ka maikaʻi diagnostic o nā kiʻi.
E ho'ēmi ana i ka hōʻike ʻana i ka radiation ma mua o kāu CT scan
Hoʻomaka lōʻihi ka pale ma mua o kou moe ʻana ma ka papa ʻaina CT Scanner. ʻO nā kaʻina hana i hana ʻia i ka wā o ka hoʻonohonoho ʻana a me ka hoʻomākaukau ʻana he mea nui ia e hōʻemi i ka hōʻike ʻana i ka radiation pono ʻole:
ʻO ka hōʻoia a me ke kūpono: ʻO ka hana koʻikoʻi e hōʻoiaʻiʻo i ka hoʻokolokolo CT Scanner pono maoli. Na kāu kauka kuhikuhi a me ka radiologist e noʻonoʻo pono i nā pōmaikaʻi diagnostic e pili ana i nā pilikia o ka radiation. Manaʻo lākou:
Hōʻike Kauka: ʻO ka CT Scanner ka hoʻāʻo maikaʻi loa e pane i ka nīnau lapaʻau kikoʻī? Hiki i kahi ʻano hana kiʻi ʻē aʻe e like me ke ultrasound a i ʻole MRI (ʻaʻole hoʻohana i ka radiation ionizing) e hāʻawi i ka ʻike e pono ai?
Kiʻi kiʻi mua: Ua loaʻa iā ʻoe nā kiʻi like like? ʻO ka nānā ʻana i nā scan mua hiki ke pale i ka hana kope ʻana.
Moʻolelo o ka maʻi: He mea koʻikoʻi nā mea e like me ka makahiki, ke kūlana hāpai, a me ka mōʻaukala o ka hōʻike ʻana i ka radiation. ʻOi aku ka maʻalahi o nā keiki a me nā ʻōpio i ka radiation.
Hoʻonui i ka Scan Protocol: I ka manawa i ʻāpono ʻia, hoʻoponopono ka hui radiology i ka protocol CT Scanner kūikawā no ʻoe a me kāu nīnau lapaʻau. Hoʻopili kēia hoʻonui ʻana:
ʻO ka palena o ke kiʻekiʻe kiʻekiʻe: E wehewehe pono i ka ʻāpana anatomical e nānā ʻia e pale aku i ka hoʻomālamalama ʻana i nā ʻāpana kino pono ʻole.
ʻO nā hoʻonohonoho hoʻololi hoʻololi: ʻo nā ʻōnaehana CT Scanner hou he polokalamu maʻalahi (e like me Automatic Exposure Control - AEC) e hoʻoponopono ʻokoʻa i ka hoʻopuka radiation i ka manawa maoli e pili ana i ka nui o ka mea maʻi a me ka nui o ka ʻāpana kino e nānā ʻia. Loaʻa i nā wahi ʻoi aku ka lahilahi a i ʻole nā wahi mānoanoa liʻiliʻi.
Koho kVp a me mAs: Koho ka mea radiologist a i ʻole ka ʻenehana i ke kinikini paipu maikaʻi loa (kVp) a me ka huahana manawa-manawa (mAs) - nā mea hoʻoholo mua o ka nui o ka radiation - ma muli o ka nui o ka mea maʻi a me ka hana diagnostic. Hoʻohana ʻia nā hoʻonohonoho haʻahaʻa i kēlā me kēia manawa e ʻae ʻia ka diagnostically.
Nā Algorithms Hoʻoponopono Hou: He holomua ʻenehana nui kēia. Ma kahi o ka kānana hope kuʻuna, hoʻohana hou ka hana hou ʻana i nā hiʻohiʻona makemakika paʻakikī a me nā ʻenehana hoʻohaʻahaʻa walaʻau no ka hana ʻana i nā kiʻi kiʻekiʻe mai ka ʻike haʻahaʻa haʻahaʻa haʻahaʻa. Ke alakaʻi nei i nā mea hana CT Scanner e like me nā mea i hōʻike ʻia ma nā paepae e like me Mecan Medical e hoʻolaha nui nei i kēia mau mea hiki ke hōʻemi i ka dosis. No ka laʻana, hiki i nā ʻōnaehana kiʻekiʻe ke hōʻemi i ka nui ma 30-60% i hoʻohālikelike ʻia me nā ʻano hana hou o ka wā kahiko i ka wā e mālama ai a hoʻomaikaʻi paha i ka maikaʻi o ke kiʻi.
Nā ʻōlelo aʻoaʻo no ka hoʻomākaukau ʻana i nā mea maʻi: He mea nui ke kamaʻilio maʻalahi:
Wehe i nā mea metala: ʻO nā mea metala, nā lole me nā zippers a i ʻole nā paʻi, a i ʻole kekahi mau lāʻau lapaʻau hiki ke hana i nā mea kiʻi ma nā kiʻi. Pono paha kēia mau mea kiʻi i kahi scan hou, e pāpālua i ka nui o ka radiation. ʻO ka hahai ʻana i nā ʻōlelo aʻoaʻo e wehe i ka metala e pale i kēia.
ʻO ka hoʻokē ʻai no ka ʻokoʻa: Inā makemake kāu hōʻike CT Scanner i nā mea hoʻohālikelike intravenous (IV), hiki ke noi ʻia ʻoe e hoʻokē ʻai no kekahi mau hola ma mua. ʻOiai ka mea nui no ka palekana a me ka maikaʻi o ke kiʻi, e hōʻoiaʻiʻo nō hoʻi kēia i ka holo ʻana o ka scan me ka ʻole o ka lohi e hiki ke alakaʻi i ka hopohopo a i ʻole ka neʻe ʻana e pono ai e hana hou.
ʻO ka ʻōlelo hoʻolaha hāpai: He mea nui e hoʻomaopopo i ka ʻenehana CT Scanner a me kāu kauka inā loaʻa paha ʻoe i ka hāpai ʻana. ʻOiai e hoʻopili pono ʻia ka kukuna radiation pololei i kahi o ka hoihoi, hiki ke hoʻopuehu ʻia ka pāhawewe i nā wahi ʻē aʻe o ke kino. E mālama ʻia nā ʻōlelo kiaʻi kūikawā, me ka pale ʻana i ka ʻōpū a i ʻole ka hoʻopanee ʻana i ka scan, inā hōʻoia ʻia a kānalua paha.
Ka pale ʻana i kou kino mai ka radiation i ka wā o kāu scan
Ke kau ʻia ʻoe ma ka ʻO ka papaʻaina CT Scanner , ke neʻe nei ka manaʻo i ka hoʻokō ʻana i nā palekana kino a me ka ʻenehana i ka wā o ka loaʻa kiʻi maoli:
Palekana ma muli o nā lako lako:
No nā ʻŌnaʻi Kuʻuna Ma waho o ke kahua ʻimi: Inā mamao ka wahi scan mai nā mea radiosensitive loa e like me ka thyroid, ka ū, a i ʻole nā gonads, hiki ke kau ʻia kahi apron alakaʻi a i ʻole nā pale kūikawā (e laʻa, nā pale umauma bismuth, nā pale gonad) hiki ke kau ʻia ma luna o kēia mau wahi i mea e pale ai i ka radiation. He mea koʻikoʻi kēia no nā maʻi pediatric a me nā poʻe ʻōpio.
No nā limahana: Hoʻohana nā ʻenehana i ka CT Scanner mai kahi lumi hoʻomalu i pale ʻia e nā paia a me nā puka aniani. Ke komo wale nei lākou i ka lumi scan inā pono, me ka hoʻohana ʻana i nā pale kepau inā pono lākou e kokoke i ka mea maʻi i ka wā o ka hoʻonohonoho ʻana a i ʻole ka injection.
Lead Aprons and Shields: ʻOiai ʻaʻole maʻamau ka hoʻohana pololei ʻana i ke kahua scan no ka loaʻa ʻana o CT Scanner helical hou (no ka mea hiki iā lākou ke hana i nā mea kiʻi a hoʻopilikia i ka AEC), hoʻohana mau ʻia ka pale pale alakaʻi:
Hoʻopili: Ke hoʻohana nei ka CT Scanner i nā collimators beam pololei e hoʻolike i ka kukuna X-ray a paʻa i ka laulā o nā mea ʻike a me ka mānoanoa ʻāpana kikoʻī e pono ai. Hoʻemi kēia i ka nui o ka ʻiʻo i hoʻomālamalama ʻia ma waho o ka wahi o ka hoihoi, e hōʻemi ana i ka ʻike ʻana o ka beam mua a me ka lūlū.
ʻO Advanced CT Scanner Technologies: ʻO ka hoʻolālā a me nā hiki o ka CT Scanner ponoʻī nā mea hana ikaika loa no ka hōʻemi ʻana i ka nui i ka wā o ka scan.
ʻO ka Mana Hoʻolaha Aunoa (AEC): E like me ka mea i ʻōlelo ʻia ma mua, he maʻamau kēia ma nā ʻōnaehana CT Scanner hou. Ana nā mea ʻike i ka attenuation o nā kukui X e hele ana i ka mea maʻi i ka manawa maoli i ka wā e kaʻa ai ka paipu. Hoʻoponopono koke ka ʻōnaehana i ke au o ka paipu (mA) e hāʻawi i ka radiation liʻiliʻi e pono ai no ke kiʻi diagnostic ma kēlā me kēia kūlana angular kikoʻī a me ka pae anatomical. ʻOi aku ka maikaʻi o kēia ma mua o ka hoʻohana ʻana i kahi paʻa, kiʻekiʻe kiʻekiʻe no ka scan holoʻokoʻa.
ʻO ka Iterative Reconstruction (IR) a me AI-Driven Reconstruction: ʻO kēia paha ka holomua nui loa. Pono nā ʻano hana kuʻuna kuʻuna (Filtered Back Projection - FBP) i ka nui o ka radiation no ka hana ʻana i nā kiʻi me nā pae leo kūpono. Hana ʻia nā algorithms IR me ka hoʻohālikelike ʻana i ka ʻikepili i hoʻohālikelike ʻia me kahi kiʻi i hoʻohālikelike ʻia, e hoʻoponopono ana i ka walaʻau a me ka like ʻole. ʻO nā ʻōnaehana kiʻekiʻe, e like me nā mea i hāʻawi ʻia e ke alakaʻi ʻana i nā mea hoʻolako CT Scanner, hoʻokomo i ka naʻauao artificial (AI) e hoʻonui hou i ka hoʻohaʻahaʻa leo a me ka maikaʻi o ke kiʻi mai ka loaʻa ʻana o ka ultra-low-dose. Hāʻawi kēia i ka hoʻemi nui ʻana (pinepine 50% a i ʻole ke hoʻohālikelike ʻia me FBP) me ka ʻole o ka mōhai ʻana i ka hilinaʻi diagnostic.
Spectral CT (Dual-Energy CT): Hiki i kekahi mau ʻōnaehana CT Scanner kiʻekiʻe ke loaʻa ka ʻikepili ma nā pae ikehu X-ray like ʻole i ka manawa like. Hāʻawi kēia i nā ʻike kikoʻī hou aʻe (e laʻa, ka hoʻokaʻawale ʻana i ka waika uric mai ka calcium i loko o nā pōhaku kīkī, a i ʻole ka wehe ʻana i nā iwi mai nā kiʻi vascular). Hiki i ka Spectral CT ke hoʻololi i nā scan he nui a i ʻole e hoʻohana i nā protocols haʻahaʻa ma o ka hāʻawi ʻana i ka ʻike hou aʻe mai kahi loaʻa hoʻokahi.
Photon-Counting Detectors (PCD): E hōʻike ana i ka ʻoki ʻana o ka ʻenehana CT Scanner, helu pololei nā PCD i nā kiʻi X-ray pākahi a ana i ko lākou ikehu. Hāʻawi kēia i ka ʻoi aku ka maikaʻi o ka hoʻohana ʻana (ka haʻahaʻa haʻahaʻa no ka maikaʻi o ke kiʻi like), hoʻomaikaʻi i ka hoʻonā spatial, a hoʻonui i nā mana spectral i hoʻohālikelike ʻia me nā mea ʻike hoʻohui i ka ikehu maʻamau. ʻOiai ʻaʻole i loaʻa i nā wahi āpau, puka koke ʻo PCD-CT ma ke ʻano he mea hoʻololi pāʻani no ke kiʻi kiʻi ultra-low-dose.
Ka Hui Hoʻomanawanui: He mea koʻikoʻi kāu kuleana i ka wā o ka scan no ka maikaʻi o ke kiʻi a me ka hōʻemi ʻana i ka nui:
Paʻa Paʻa: ʻO kēlā me kēia neʻe i ka wā o ka loaʻa ʻana o ka CT Scanner ke kumu o ka blurring a me nā mea kiʻi. Inā ʻaʻole ʻike ʻia nā kiʻi, pono paha e hana hou ʻia ka scan, e pāpālua i kāu ʻike radiation. He mea nui ka hahai pono ʻana i nā ʻōlelo kuhikuhi hanu (e laʻa, 'hoʻopaʻa i kou hanu'), ʻoi aku ka nui no ka nānā ʻana i ka umauma a me ka ʻōpū.
Hoʻonohonoho: ʻO ka hoʻonohonoho kūpono e like me ka ʻōlelo a ka ʻenehana e hōʻoia i ka uhi ʻana o ka scan i ka wahi i manaʻo ʻia me ka maikaʻi a hoʻemi i ka pono o nā scan hou.
Nīnau pinepine
Nīnau: He pōʻino anei ka radiation mai kahi CT Scanner? A: ʻO ka nui o ka radiation mai kahi hoʻokahi, pono i ka lāʻau CT Scanner scan ke manaʻo nui ʻia e lawe i kahi pilikia liʻiliʻi loa, ʻoi aku no nā pākeke. ʻOi aku ka maikaʻi o kahi hōʻailona pololei ma mua o kēia pilikia liʻiliʻi. Eia nō naʻe, mālama pono ʻia ka loina o ALARA e mālama i ka haʻahaʻa e like me ka hiki. He kumulative ka pilikia, no laila e pale mau ʻia nā scans pono ʻole.
Nīnau: Pehea e hoʻohālikelike ai ka radiation mai kahi CT Scanner me nā kumu ʻē aʻe? A: E nānā i ka papa ma lalo no ka hoʻohālikelike ʻana:
Pūnaewele Puna
Maʻamau Maʻamau Pono (mSv)
Manawa Kaulike o ka Pākuʻi Kūlohelohe
X-ray o ka umauma hoʻokahi
0.1
~ 10 lā
Holo kaapuni mai NY a LA
0.04
~4 lā
Mammogram (nānā hoʻokahi)
0.4
~7 pule
ʻO ke poʻo CT Scanner
1-2
~ 6 mahina - 1 makahiki
ʻĀkau CT Scanner
5-7
~ 2 - 3 makahiki
ʻĀpana/Pelvis CT Scanner
7-10
~3 - 4 makahiki
ʻAwelika Makahiki Makahiki Lāʻulaʻula (US)
3.0
1 makahiki
Nīnau: Ua ʻoi aku ka maʻalahi o nā keiki i ka radiation CT Scanner? A: ʻAe. Hoʻokaʻawale wikiwiki nā keiki a me ka lōʻihi o ke ola ma mua, ʻo ia hoʻi, ʻoi aku ka manawa e hōʻike ʻia ai nā hopena radiation. Loaʻa iā lākou kahi maʻi ʻoi aku ka maikaʻi no ka scan like i hoʻohālikelike ʻia me kahi kanaka makua no ka mea ʻoi aku ko lākou mau kino liʻiliʻi i ka nui o ka radiation e pili ana i ko lākou nui. No laila, hoʻoponopono pono ʻia nā protocols CT Scanner no nā keiki ('pediatric protocols') me ka hoʻohana ʻana i nā hoʻonohonoho haʻahaʻa haʻahaʻa, AEC kūikawā, a me nā ʻenehana IR. Hoʻohana pinepine ʻia ka pale ʻana i nā ʻāpana koʻikoʻi.
Nīnau: He aha ka mea e hana ʻia i mea e palekana ai ka ʻimi ʻana o CT Scanner? A: Ke ulu mau nei ke kahua. Loaʻa nā ʻano nui:
ʻOi aku ka hoʻohana ʻana o Iterative & AI Reconstruction: ʻO kēia ke kumu nui loa e hiki ai i ka nānā ʻana i ka ultra-low-dose maʻamau.
Advanced Dose Modulation: ʻO nā ʻōnaehana AEC ʻoi aku ka maʻalahi e hoʻololi pololei i ka anatomy maʻi.
Spectral CT: E hōʻemi ana i ka pono no nā scan he nui a hiki i nā protocols haʻahaʻa.
Photon-Counting CT: Ke hāʻawi nei i nā hoʻomaikaʻi hou i ka maikaʻi o ka dose a me ka maikaʻi o ke kiʻi.
Hoʻoponopono koʻikoʻi a me ka ʻae ʻana: Pono nā ʻoihana e pili i nā palena palena koʻikoʻi a me nā papahana hoʻokele maikaʻi (e laʻa, ACR accreditation ma US).
Ka nānā ʻana a me ka hoʻopaʻa ʻana: nā ʻōnaehana e hoʻopaʻa a hoʻopaʻa i ka nui o ka radiation maʻi ma waena o nā hoʻokolohua kiʻi he nui e pale i ka overexposure cumulative.
Nīnau: Pono au e hopohopo e pili ana i nā mea hoʻohālikelike? A: Hoʻohana ʻia nā mea hoʻohālikelike IV (iodine-based) a i ʻole waha/rectal contrast agents i kekahi manawa no ka hoʻomaikaʻi ʻana i ka maikaʻi o ke kiʻi ma o ka hōʻike ʻana i nā kīʻaha koko a i ʻole nā ʻāpana kikoʻī. ʻOiai palekana maʻamau, lawe lākou i nā pilikia ʻē aʻe (e laʻa, ka hopena maʻi, nā pilikia puʻupaʻa) ma mua o ka radiation. Hoʻoholo ʻia ka hoʻohana ʻana i ka ʻokoʻa ma muli o ka pono diagnostic, e kaupaona ana i kāna mau pōmaikaʻi i kēia mau pilikia kūikawā, kūʻokoʻa i ka nui o ka radiation mai ka CT Scanner.
Nīnau: Pehea e hiki ai iaʻu ke hōʻoiaʻiʻo e hoʻohana ana kaʻu wahi CT Scanner i nā ʻenehana haʻahaʻa? A: ʻO nā keʻena kaulana e hoʻokumu i ka palekana radiation. ʻimi i:
ʻAe ʻia: E like me ka American College of Radiology (ACR) a i ʻole nā kino like ma nā ʻāina ʻē aʻe, e kauoha ana i ka hoʻopaʻa ʻana a me ka nānā ʻana.
Nā Mea Hana Hou: Loaʻa i nā ʻenehana hōʻemi hōʻemi hōʻemi hou loa (AEC, IR, CT spectral paha).
Nā limahana i hoʻomaʻamaʻa ʻia: nā mea ʻenehana radiologic i hōʻoia ʻia a me nā radiologists i hoʻomaopopo a hoʻohana pono i nā kumu ALARA.
Ka Mākaʻikaʻi Dose: Pono e hiki i nā keʻena ke hāʻawi i ka ʻike e pili ana i nā kau maʻamau no kā lākou hoʻokolohua a komo i loko o nā kākau inoa.
