| Περίληψη: | During hospitalisation in the SCBU premature neonates may undergo a significant number of radiographic procedures to assist mainly in the diagnosis and management of lung diseases, which represent one of the most life threatening conditions in the newborn. Additionally, repeated radiographs are required to confirm correct positioning of tubes and catheters inserted during the course of their management.
Special attention should be paid in optimising exposures, as neonates have an increased risk of radiation induced malignancy compared to adults due to the high radiosensitivity of mitotic cells and their longer life expectancy.
Another consideration in the frequent imaging of neonates, while in the SCBU, is that handling of the neonate should be minimised. Current clinical practice mainly involves positioning the cassette on the bed directly behind the neonate. However, lifting or moving the infant to position the cassette, can lead to hypoxia, bradycardia, cerebral haemorrhage and could cause accidental dislodgment of tubes, lines and probes. Additionally, medical and nursing issues include increased risk of cross infection and changes in the stable microenvironment of the incubator, e.g. humidity and temperature. Modern incubators incorporate an imaging tray under the bed to facilitate placement of the radiographic cassette without the need to disturb the infant. Paediatricians and nurses urge the use of the tray for the benefit of the neonate. One the other hand, great concerns form the radiographers were expressed, regarding increased dose and poor image quality due to greater attenuation of the beam, as well as for repeat exposures due to artifacts or misalignment.
The current study was divided in three parts. The first objective of the study was to perform a survey of the doses encountered in two Special Care Baby Units, one at the University Hospital of Patras in Greece and the other one at the Royal Victoria Infirmary in Newcastle upon Tyne in the UK.
The first part of this study was performed in Greece and an optimized radiographic protocol for film-screen was suggested according to neonatal birth weight. In the second part, realized in the UK, the use of the incubator imaging tray is investigated for positioning the CR cassette, with regards to detector dose, exposure index, image quality and radiation dose to patient. Part three is studying the effect of the new tissue radiosensitivity factors, published in the new report from the International Commission on Radiological Protection 2007, on the effective dose conversion coefficients in computed tomography examinations in paediatric patients.
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