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Titre : | Loptimisation de la dose dans le cadre de luréthro-cystographie rétrograde et per-mictionnelle pédiatrique (UCM) |
Auteurs : | Yassine SETTI, Auteur ; Mohammed Ouertani, Promoteur |
Type de document : | Travail de fin d'études |
Editeur : | Bruxelles : Institut Paul Lambin, 2020 |
Langues: | Français |
Index. décimale : | TFE - Imagerie médicale |
Résumé : |
The cystography (VCUG) is an exam that aims to diagnose the vesicoureteral reflux (VUR). There are many indications but one of these is febrile events without explanation. The vast majority of examinations are performed during childhood and infancy, even during the neonatal period. The goal of this work is not to talk about the indications but to optimize the practice of the VCUG at Delta Hospital (CHIREC Brussels). We noticed that some Radiologists acquire images with fluoroscopy only, others with radiography only and some with both. If one wants to assert or rule out VUR, VCUG is unavoidable as far as it is the gold standard. Therefore, it is of utmost importance to be ALARA when we perform this examination that is to say to get the complete medical information with the minimal irradiation.
Method We changed some elements like radiological focus, some practices like working without grid, without zoom and with additional filtration. A trial from 2015 to February 2020 has been conducted on 197 children having an age between 0 and 3 years to evaluate the changing in the dose. Also, from October 2019 the radiographers began to adjust the light field and the centering of the tube. Since 2017, the two radiologists whom I followed in this study stopped performing radiographs during VCUG. Results The trial showed that as a consequence of our changes and by systematically using fluoroscopy only, we managed to reduce the dose by 86,95 % at Delta Hospital between 2018 and February 2020. We could notice that avoidance of radiography decreased the dose by only 20% in 2017. But at this moment, fluoroscopy was still often utilized to focus the points of interest during examination, which is not exactly ALARA. One should only utilize the lights. The intervention of a well trained technologist is mandatory for the right positioning of the child. Our intervention showed that capturing radiography is not necessary. Performing VCUG only with fluoroscopy and optimized practices permits to reach very low doses. Conclusion We must always think about optimization. It is not so difficult to optimize the dose just by changing practices and thinking about radioprotection. |
Accès : | Identifiez-vous avant d'accéder au document électronique |
Disponible en ligne : | Oui |
Lieu du stage : | Hôpital DELTA (CHIREC) |
Département : | Imagerie médicale |
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