Evaluation of scatter radiation to the thyroid gland attributable to brain computed tomography scan in Port Harcourt, Nigeria

Background: Computed tomography (CT) is an axial imaging modality that uses X-ray. The study is to determine the amount of X-radiation that reaches the thyroid glands during brain CT.Methods: A prospective study was carried out in Rivers State University Teaching Hospital’s Radiology Department with 60 participants sent for brain CT scan. A 64 slice helical GE Optima CT machine was used while radiation dose reaching the thyroid gland was measured with themoluminiscent dosimeter (TLD) chips (TLD LiF-100). The TLD chip was placed on the anterior aspects of the neck at the level of 6th cervical vertebra (C6) and held in place with adhesive tapes. The TLD chip was later sent to the radiation dosimetric laboratory for reading. Collected data was analyzed using SPSS windows version 22.0 statistical software. A descriptive statistical tool was used to determine central tendencies. Pearson correlation and linear regression analysis models were also used to evaluate correlation between variables.Results: The mean (±SD) CTDI, DLP and brain Effective Dose were 37.265±13.098mGy, 662.451±230.782mGy-cm and 1.667±0.603mSv respectively. The Scatter X-Radiation reaching the thyroid gland and resultant Effective Dose were 5.26±3.13mSv and 0.26±0.16mSv respectively. A positive correlation between brain and thyroid gland effective doses yielded a Pearson’s correlation coefficient (r) of 0.892 within a confidence interval of 0.01 (p value of 0.01) showing significant correlation.Conclusions: The amount of radiation received by the thyroid gland during brain computed tomography scan is significant. Therefore, it is pertinent to protect the thyroid gland during the procedure.

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A rare interesting case of fatal air embolism after intravenous contrast during computed tomography

EMERGENCY MEDICINE ◽

10.22141/2224-0586.17.4.2021.237734 ◽

2021 ◽

Vol 17 (4) ◽

pp. 93-96

Author(s):

Naved Y. Hasan ◽

Asiah Salem Rugaan

Keyword(s):

Computed Tomography ◽

Fatal Case ◽

Pulseless Electrical Activity ◽

Air Embolism ◽

Sudden Onset ◽

Radiology Department ◽

Computed Tomography Scan ◽

Intravenous Contrast ◽

Shock State ◽

Tomography Scan

We are reporting a fatal case of air embolism. Although minor cases of air embolism may go unnoticed, this is a case of fatal air embolism after intravenous entry of air, which presented with sudden onset of pulseless electrical activity during a computed tomography scan in the radiology department, requiring cardiopulmonary resuscitation for 15 min. Subsequently, after admission to the intensive care unit, we achieved return of spontaneous circulation. The patient was intubated and ventilated in a shock state. He remained in refractory shock despite of supportive care. Cardiaс arrest was registered again in the catheterization lab and the patient could not be revived after 4 h from the initial cardiac arrest. А computed tomography scan was reported to reveal a significant amount of intra-cardiac air, which was the likely cause patient’s death. The case is a rare condition, which highlights the importance of early diagnosis and delivers a message to the medical staff to have a high index of suspicion in patients who have risk factors, and who develop sudden shock with hypoxemia, in order to treat this potentially life-threatening condition effectively in a timely manner.

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