ABSTRACT
BACKGROUND: Extremely low birth weight (ELBW <1000 g) infants may have increased sensitivity to radiation exposure. Our objective was to estimate the radiation exposure in survivors of ELBW infants during their neonatal intensive care unit (NICU) stay. METHODS: In this retrospective cohort study, medical records of all ELBW infants who had been admitted to our NICU between May 1999 and October 2009 were reviewed. The infants' total entrance skin exposure [ESE in micro-Gray (µGy)] was estimated. RESULTS: Among 450 survivors, the mean gestational age (GA) was 26.3±2.1 weeks, and the mean birth weight (BW) was 774.2±144.4 g. Infants received a median of 32 (range: 1-159) X-rays, with an estimated ESE of 1471 µGy (range: 28-9264). Total ESE was inversely proportional to GA (r=-0.34; P<0.01), and BW (r=-0.39; P=0.01) and proportional to the severity of illness [score for neonatal acute physiology-perinatal extension (SNAPPE), r=0.39; P=0.01]. In a linear regression analysis, GA, SNAPPE and necrotizing enterocolitis were associated with radiation exposure (ESE) in ELBW infants (r2=0.133; P<0.001). CONCLUSIONS: During their NICU stay, ELBW infants were subjected to a significant number of diagnostic X-ray procedures. Our data highlight the need to closely monitor the number of X-ray procedures ordered to ELBW infants to avoid unnecessary radiation exposure.
Subject(s)
Infant, Extremely Low Birth Weight , Infant, Newborn, Diseases/diagnostic imaging , Intensive Care Units, Neonatal , Cohort Studies , Female , Humans , Infant, Newborn , Male , Radiation Dosage , Radiography/statistics & numerical data , Retrospective StudiesSubject(s)
Curriculum , Internship and Residency , Physics/education , Radiology/education , United StatesABSTRACT
This article on digital radiography image acquisition is the first of two articles written as part of an intersociety effort to establish image quality standards for digital and computed radiography. The topic of the other paper is digital radiography image processing and display. The articles were developed collaboratively by the ACR, the American Association of Physicists in Medicine, and the Society for Imaging Informatics in Medicine. Increasingly, medical imaging and patient information are being managed using digital data during acquisition, transmission, storage, display, interpretation, and consultation. Data management during each of these operations has a direct impact on the quality of patient care. These articles describe what is known to improve image quality for digital and computed radiography and make recommendations on optimal acquisition, processing, and display. The practice of digital radiography is a rapidly evolving technology that will require the timely revision of any guidelines and standards. This document provides a basis for the technologies available today in clinical practice and may be useful in guiding the future clinical practice of digital radiography.
Subject(s)
Data Display/standards , Practice Guidelines as Topic , Quality Assurance, Health Care/methods , Quality Assurance, Health Care/standards , Radiographic Image Enhancement/standards , Radiographic Image Interpretation, Computer-Assisted/standards , United StatesABSTRACT
The scrotum is frequently imaged on an emergent basis. The differential diagnosis of the acute scrotum can be divided into four categories-torsion, trauma, tumor, and "testiculitis" (epididymo-orchitis). Although testicular neoplasms are not imaged emergently, 15% are detected incidentally when performing an emergent scrotal ultrasound. Therefore, the emergent sonographic examination of the testicles should include a thorough search for malignancy. Images demonstrating the sonographic and color Doppler appearances of each of the "four T's" will be reviewed. The radiographic review will focus on the imaging features, which are the keys to arriving at the correct diagnosis.
