Single-bolus Versus Split-bolus Protocol in Multidetector Computed Tomography Urography
YTA Lai, BMH Lai, H Chin, KP Fung, SF Shum, WK Kan, JLS Khoo
Hong Kong J Radiol 2017;20:126-30
DOI: 10.12809/hkjr1716420
Objectives: To compare the single-bolus protocol with the split-bolus protocol in multidetector computed tomography urography in terms of image quality (opacification), radiation dose, and scan time.
Methods: Consecutive patients who received the single-bolus protocol between February and May 2014 were compared with consecutive patients who received the split-bolus protocol between May and August 2014 for elective multidetector computed tomography urography in a regional hospital in Hong Kong. The dose-length product (DLP) and scan time were recorded. The degree of opacification of the urinary tract at the renal calyces, renal pelvis, upper ureter proximal to the iliac crest, and the distal ureter was assessed. The two protocols were compared in terms of the DLP, scan time, and degree of opacification of each urinary tract segment.
Results: 105 patients aged 19 to 90 years who received the single-bolus protocol and 123 patients aged 22 to 89 years who received the split-bolus protocol were reviewed. Compared with the single-bolus protocol, the split-bolus protocol resulted in lower mean DLP (2610.4 vs. 2209.0 mGy·cm, 15.4% difference, p < 0.0001), lower estimated mean effective dose (39.2 vs. 33.1 mGy, 15.4% difference, p < 0.0001), and lower mean scan time (46.9 vs. 40.8 s, 12.9% difference, p < 0.0001). The two protocols were comparable in terms of the opacification rate at the calyces (100% vs. 98.7%, p = 0.251), renal pelvis (99.0% vs. 98.3%, p = 0.689), upper ureter (91.6% vs. 86.5%, p = 0.088), and lower ureter (83.7% vs. 85.6%, p = 0.595).
Conclusion: Compared with the single-bolus protocol, the split-bolus protocol resulted in significantly reduced radiation dose and scan time, with comparable image quality.
Authors’ affiliations:
YTA Lai, BMH Lai, H Chin, WK Kan, JLS Khoo: Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
KP Fung: Diagnostic Imaging Center, Hong Kong Adventist Hospital, Tsuen Wan, Hong Kong
SF Shum: Radiology Department, Hong Kong Baptist Hospital, Kowloon Tong, Hong Kong
中文摘要
比較多檢測電腦斷層掃描尿路造影的單次與分次推注方案
黎爾德、賴銘曦、錢凱、馮邦、岑承輝、簡偉權、邱麗珊
目的：比較多檢測電腦斷層掃描尿路造影的單次與分次推注方案對於圖像質量（不透明度）、輻射劑量和掃描時間的影響。
方法：比較在香港一所分區醫院於2014年2月至5月間接受單次推注方案的患者與於2014年5月至8月間接受分次推注方案的患者的劑量長度產品（DLP）、掃描時間和尿道的不透明度。
結果：回顧105例19至90歲接受單次推注方案的患者及123例22至89歲接受分次推注方案的患者。 與單次推注方案相比，分次推注方案導致較低平均DLP（2610.4對2209.0 mGy·cm，15.4%差異， p < 0.0001）、較低估計平均有效劑量（39.2對33.1 mGy，15.4%差異，p < 0.0001）及較低平均掃描時間（46.9對40.8秒，12.9%差異，p < 0.0001）。兩個方案的尿道的不透明度相等，包括腎盞（100%對98.7%，p = 0.251）、腎盂（99.0%對98.3%，p = 0.689）、上輸尿管（91.6%對86.5%，p = 0.088）和下輸尿管（83.7%對85.6%，p = 0.595）。
結論：與單次推注方案相比，分次推注方案的輻射劑量和掃描時間顯著降低，並具相等圖像質量。