scholarly journals Application of 70 kVp in abdominal CT angiography to reduce both radiation and contrast dosage and improve patient comfort for children

2021 ◽  
pp. 1-9
Author(s):  
Jihang Sun ◽  
Haoyan Li ◽  
Lixin Yang ◽  
Zuofu Zhou ◽  
Michelle Li ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Injection Pressure ◽  
Patient Comfort ◽  
Control Group ◽  
Study Group ◽  
Contrast Dose ◽  
Improve Patient Comfort ◽  
Improve Patient ◽  
Large Vessels ◽  
Contrast Dosage

BACKGROUND: Low-tube voltage scanning improves CT attenuation value of contrast medium (CM). Thus, we hypothesized that 70 kVp in pediatric abdominal CT angiography (CTA) could be used to reduce both radiation and CM dose and improve patient comfort at the same time. OBJECTIVE: To evaluate the feasibility of using 70 kVp in pediatric abdominal CTA to reduce radiation dose and CM dose and improve patient care for children. MATERIALS AND METHODS: Forty-six children needing abdominal CTA were enrolled in the study group using low-dose scanning protocol with 70 kVp and 0.7–1.1 ml/kg contrast dose, and reconstructed with 50%ASIR-V. They were compared with other 46 children in control group with matching body weight and underwent conventional CT scans with 100 kVp, 1.2–1.8 ml/kg contrast dose and reconstructed using 50%ASIR. Image quality of large vessels was evaluated using a 5-point scale. CT value and standard deviation of descending aorta (Ao) was measured, and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Radiation dose, contrast dose, the maximum injection pressure between the two groups were also compared. RESULTS: Score for displaying large vessels by 70 kVp images was 3.91±0.28, lower than that (4.17±0.38) of the control group (p <  0.05), but fully met the diagnostic requirements. CT value of Ao was 390.87±86.79HU in study group, which is higher than 343.93±49.94HU in control group, while there was no difference in SNR and CNR between two groups; the radiation dose, contrast dosage and injection pressure of the study group were 1.23±0.39mGy, 12.67±7.27 ml and 43.83±17.16psi, respectively, which are significantly lower than the 1.95±0.37mGy, 22.67±7.39 ml, and 77.59±19.68psi of control group. CONCLUSION: Use of 70 kVp in pediatric abdominal CTA provides diagnostic quality images while significantly reduce radiation and contrast dose, as well as injection pressure to improve patient comfort for children.

scholarly journals Application of 70kVp in abdominal CT angiography to reduce both radiation and contrast dosage and improve patient comfort for children

2020 ◽  
Author(s):  
Jihang Sun ◽  
Haoyan Li ◽  
Lixin Yang ◽  
Jianying Li ◽  
Zuofu Zhou ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Injection Pressure ◽  
Patient Comfort ◽  
Control Group ◽  
Study Group ◽  
Abdominal Ct ◽  
Contrast Dose ◽  
Improve Patient ◽  
Large Vessels ◽  
Contrast Dosage

Abstract Objective To evaluate the application of 70kVp in pediatric abdominal CT angiography (CTA) to reduce radiation and contrast dose and improve patient comfort. Methods Forty-six children needing abdominal CTA were enrolled in the study group using low-dose scanning protocol with 70kVp and 0.7-1.1ml/kg contrast dose, and reconstructed with 50%ASIR-V. They were compared with another 46 children (control group) with matching body weight who underwent conventional CT scans with 100kVp, 1.2-1.8ml/kg contrast dose and reconstructed using 50%ASIR. The image quality of large vessels was evaluated using a 5-point scale, and the number of superior mesenteric artery branches identifiable by CAD was recorded. The CT value and standard deviation of descending aorta (Ao) was measured, and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) calculated. Radiation dose, contrast dose, the maximum injection pressure, correlation between flow rate and injection pressure were compared between the two groups. Results The score for displaying large vessels by 70kVp images was 3.91±0.28, and up to 3 superior mesenteric artery branches could be identified, all of which met the diagnostic requirements. The CT value of Ao was 390.87±86.79HU in the study group, higher than 343.93±49.94HU in the control group, while no difference in SNR and CNR between the two groups; the radiation dose, contrast dosage and injection pressure of the study group were 1.23±0.39mGy, 12.67±7.27ml and 43.83±17.16psi respectively, significantly lower than the 1.95±0.37mGy, 22.67±7.39ml, and 77.59±19.68psi of the control group. The correlation coefficients between flow rate and injection pressure were 0.82 and 0.86 in 70kVp group and 100kVp group. Conclusion 70kVp scanning meets the diagnostic requirements in pediatric abdominal CTA while providing significant radiation dose, contrast dose and injection pressure reduction.

scholarly journals Music-based magnetic resonance fingerprinting to improve patient comfort during MRI examinations

2015 ◽  
Vol 75 (6) ◽  
pp. 2303-2314 ◽  
Author(s):  
Dan Ma ◽  
Eric Y. Pierre ◽  
Yun Jiang ◽  
Mark D. Schluchter ◽  
Kawin Setsompop ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Patient Comfort ◽  
Improve Patient Comfort ◽  
Improve Patient

Dilute Brimonidine to Improve Patient Comfort and Subconjunctival Hemorrhage After LASIK

2013 ◽  
Vol 29 (7) ◽  
pp. 469-475 ◽  
Author(s):  
Theodore A. Pasquali ◽  
Adam Aufderheide ◽  
Jason P. Brinton ◽  
Michele R. Avila ◽  
Erin D. Stahl ◽  
...  
Keyword(s):  
Patient Comfort ◽  
Subconjunctival Hemorrhage ◽  
Improve Patient Comfort ◽  
Improve Patient

scholarly journals 465 Split-thickness Skin Graft Harvest under Local Anaesthetic: A Single Pass Technique

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Begaj ◽  
C Asher ◽  
A Hamilton
Keyword(s):  
Skin Graft ◽  
Local Anaesthetic ◽  
Donor Site ◽  
Patient Comfort ◽  
Split Thickness Skin Graft ◽  
Uniform Thickness ◽  
Thickness Skin ◽  
Improve Patient Comfort ◽  
Anaesthetic Mixture ◽  
Improve Patient

Abstract Adequate local anaesthetic, in harvesting a split thickness skin graft (SSG), involves multiple passes of a needle across the length and width of the marked donor site. We describe a technique using hyaluronidase to uniformly anaesthetise an SSG donor site with one injection, in one pass of one needle. Mix 10mls 1% Lidocaine solution with Adrenaline 1:200,000 with 1 vial Hyaluronidase 1 Unit/ml solution. The mixture is buffered with 1 ml NaHCO3 to neutralise acidity and minimise pain. Mark out the SSG donor site Using a 27G long needle (sterican), enter perpendicular to the skin in the middle of the proximal aspect of the donor site. Inject some local anaesthetic subdermally, creating a mound. Change the angle of the needle to 180 degrees and continue to inject the remaining anaesthetic along one half of the width of the donor site. Using a rolled 4x4 swab, apply firm advancing pressure to distribute the mound across the remaining width and length of marked donor site. As the mound advances, the hyluronidase/anaesthetic mixture will distribute uniformly across the donor site within the same plane. The skin blanches secondary to the adrenaline during its distribution. The technique described is a fast, reproducible way to improve patient comfort through the elimination of repeated passes of a needle, distribute the anaesthetic uniformly across the donor site, and facilitate the acquisition of an SSG of uniform thickness The technique described is a fast, reproducible way to improve patient comfort through the elimination of repeated passes of a needle, distribute the anaesthetic uniformly across the donor site, and facilitate the acquisition of an SSG of uniform thickness

Femoral Closure – Devices and Strategies in 2010

2010 ◽  
Vol 5 (1) ◽  
pp. 93
Author(s):  
Benjamin H Holland ◽  
Robert J Applegate ◽  
◽  
Keyword(s):  
First Generation ◽  
Vascular Complications ◽  
Patient Comfort ◽  
Manual Compression ◽  
Single Centre ◽  
Access Site ◽  
Vascular Closure Devices ◽  
Improve Patient Comfort ◽  
Post Hoc ◽  
Improve Patient

Vascular closure devices (VCDs) reduce the time to haemostasis and ambulation and improve patient comfort compared with manual compression in patients undergoing vascular procedures from a femoral artery access site. Recent large, single-centre studies andpost hocdata from the Acute Catheterization and Urgent Intervention Triage strategY (ACUITY) trial strongly suggest that newer generations of VCD decrease rates of vascular complications compared with manual compression, in contrast to earlier evaluations of first-generation devices. Unfortunately, utilisation of VCDs remains limited and mitigates the potential benefit that could result from expanded use of these devices. Newer entrants into the VCD market such as Starclose and Mynx are based on extravascular closure methodology. These devices address concerns of intravascular components of a VCD; however, whether these devices reduce vascular complications and bleeding has not been evaluated. In this brief article, we will examine these factors in greater detail and suggest an algorithm for VCD use in clinical practice.

Ultra-low-dose computed tomography and its utility in wrist trauma in the emergency department

2021 ◽  
pp. 028418512198995
Author(s):  
Erdal Tekin ◽  
Kutsi Tuncer ◽  
Ibrahim Ozlu ◽  
Recep Sade ◽  
Rustem Berhan Pirimoglu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Radiation Dose ◽  
Low Dose ◽  
Standard Dose ◽  
Control Group ◽  
Study Group ◽  
Effective Radiation Dose ◽  
Wrist Trauma ◽  
Effective Radiation

Background The use and frequency of computed tomography (CT) are increasing day by day in emergency departments (ED). This increases the amount of radiation exposed. Purpose To evaluate the image quality obtained by ultra-low-dose CT (ULDCT) in patients with suspected wrist fractures in the ED and to investigate whether it is an alternative to standard-dose CT (SDCT). Material and Methods This is a study prospectively examining 336 patients who consulted the ED for wrist trauma. After exclusion criteria were applied, the patients were divided into the study and control groups. Then, SDCT (120 kVp and 100 mAs) and ULDCT (80 kVp and 5 mAs) wrist protocols were applied simultaneously. The images obtained were evaluated for image quality and fracture independently by a radiologist and an emergency medical specialist using a 5-point scale. Results The effective radiation dose calculated for the control group scans was 41.1 ± 2.1 µSv, whereas the effective radiation dose calculated for the study group scans was 0.5 ± 0.0 µSv. The effective radiation dose of the study group was significantly lower than that of the control group ( P < 0.01). The CT images in the study group showed no significant differences in the mean image quality score between observer 1 and observer 2 (3.4 and 4.3, respectively; P = 0.58). Both observers could detect all fractures using the ULDCT images. Conclusion ULDCT provides high-quality images in wrist traumas while reducing the radiation dose by approximately 98% compared to SDCT without any changes in diagnostic accuracy.

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