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OBJECTIVE@#In order to solve the problem of inadequate CT screening ability in emergency medical rescue in remote mountainous areas, high-altitude areas, other public health events and sudden natural disasters, a vehicle-mounted mobile CT suitable for emergency medical rescue is studied.@*METHODS@#A vehicle chassis system suitable for long-distance transportation and a cabin system suitable for epidemic prevention and control was designed. A domestic 32-slice CT with small volume, light weight and high stability was selected to design a vehicle-mounted mobile CT suitable for emergency medical rescue.@*RESULTS@#The high-performance vehicle-mounted mobile CT can provide rapid support, and provide large-scale screening, emergency medical rescue, a supplement to daily CT scanning in peacetime and wartime.@*CONCLUSIONS@#The vehicle CT has high stability, fast scanning speed and high social and economic value.
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@#Objective To explore the application of Body Tom® mobile CT combined with basic anesthesia in preoperative painless positioning of small pulmonary nodules, and evaluate its safety and effectiveness. Methods Patients using mobile Body Tom® CT to accurately locate pulmonary nodules in the Department of Thoracic Surgery of Affiliated Nanjing Brain Hospital, Nanjing Medical University from August to October 2022 were retrospectively included. Clinical data of the whole patient group were analyzed. Results We finally included 30 patients with 12 males and 18 females at age of 23-71 years. The position success rate of 30 patients with small pulmonary nodules was 100.0%. Location time was 14.20±4.07 min. There was one patient of intrapulmonary hemorrhage, with no other complications such as pneumothorax, positioning needle shedding, or pleural reaction. The time from the end of positioning to the start of surgery was 12.63±5.68 min. There was no needle migration or indocyanine green overflow. All patients completed resection of small pulmonary nodules under single-port thoracoscopy, no transit to opening chest. The average operation time was 85.32±12.60 min. There was no postoperative complications, and the average postoperative chest tube retention time was 2.12±1.34 days. And the average length of hospital stay was 3.52±1.45 days. The postoperative pathological results showed that the distance from the nodules was greater than 2 cm. Conclusion Body Tom® mobile CT combined with basic anesthesia can achieve the preoperative painless, precise positioning of pulmonary nodules, effectively reduce the incidence of preoperative positioning complications, shorten the operation waiting time, ensure the safety and effectiveness of patients with preoperative pulmonary nodules positioning, and further improve the surgical comfort of patients, which has certain clinical application value.
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Objective To measure the peripheral dose distributions of the mobile head cone beam computed tomography (CBCT) and evaluate the impact of CBCT on the surrounding personnel and environment, and provide data support for clinical radiation protection management. Methods Combined with the structural characteristics of CBCT, AT1123 was used in the direction of 0° (counterclockwise), 45°, 90°, 135°, 180°, 225°, 270° and 315° in front of CBCT to measure the ambient dose equivalent rate of 30 cm, 80 cm and 130 cm away from the ground when the equipment was normally out of the beam, and the boundary of the temporary control area was drawn. At the same time, the dose level behind the lead screen 1 m away from the external surface of the equipment was measured and analyzed. Results The dose field around CBCT was symmetrically distributed with the dividing line of 0° and 180°, and the radiation dose level of 5.5 m in the direction of 0°, 3.5 m in the direction of 45°, 0.5 m in the direction of 90° and within 1.0 m in the direction of 180° (inside the "spoon" type) was higher than 2.5 μSv/h. The radiation dose levels of CT aperture 0° (straight forward), 45° and 315° behind the lead screen 1 m away from the equipment surface were 0.37 μSv/h, 0.22 μSv/h and 0.54 μSv/h, respectively. Conclusion The results show that the radiation dose around the mobile head cone beam CT is in a low dose level, the distribution of the dose field can provide necessary reference for the administrative and medical personnel to strengthen the radiation safety management. At the same time, it is suggested that lead screens should be set up in the clinical use of mobile CT to ensure the health and safety of the surrounding people and the environment.
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Objective:To compare the efficacy and safety of domestic 16-row and imported 8-row mobile CT in clinics.Methods:A total of 1469 patients accepted domestic 16-row mobile CT head scans (1604 times) from March 2017 to August 2018 in Bayi Brain Hospital Affiliated to 7 th Medical Center of General Hospital of People's Liberation Army and Langfang Aidebao Hospital; and 15510 patients accepted imported 8-row mobile CT head scans (24994 times) from January 2016 to August 2018 in Bayi Brain Hospital Affiliated to 7 th Medical Center of General Hospital of People's Liberation Army. All patients underwent horizontal plain and enhanced head scans, cerebral CT angiography (CTA), and helical 3D imaging; and the imaging quality, operating power consumption, computed tomography dose index volume (CTDIvol) and stability within scanning volume ranges under different scanning modes of the two CT scans were compared. Results:(1) Imaging quality: the horizontal scanning of domestic 16-row mobile CT could clearly display low-density tissues such as the eyeball, optic nerve, brain stem, sulcus and cerebral gyrus; the imaging quality of both CT scans in patients with traumatic subdural hematoma and ischemic stroke completely met the clinical diagnosis and treatment standards. (2) Operating power consumption: the per-hour operating power consumption of domestic 16-row mobile CT ([0.286±0.018] kW·h) was obviously lower than that of imported 8-row mobile CT ([0.485±0.028] kW·h). (3) Radiological hazard: the CTDIvol of the horizontal scanning volume range in domestic 16-row mobile CT ([36.270±0.281] mGy) was significantly lower than that in the imported 8-row mobile CT ([82.520±0.441] mGy, P<0.05); the CTDIvol of enhanced axis scan volume range in the domestic 16-row mobile CT ([36.270±0.335] mGy) was significantly lower than that in the imported 8-row mobile CT ([70.728±0.424] mGy, P<0.05); the CTDIvol in the volume of CTA imaging of domestic 16-row mobile CT ([20.600±0.087] mGy) was significantly lower than that in the imported 8-row mobile CT ([29.300±0.335] mGy, P<0.05). The domestic 16-row mobile CT was designed with shock absorbers and guides; domestic 16-row mobile CT had small load, a low center of gravity, and good stability as compared with imported 8-row mobile CT. Conclusion:In terms of head scanning applications, the imaging quality of domestic 16-row mobile CT and imported 8-row mobile CT is in full compliance with clinical diagnostic standards, but the energy consumption and radiation risk of domestic 16-row mobile CT is significantly lower than imported 8-row mobile CT, enjoying good stability as compared with imported 8-row mobile CT.
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Objective:To assess the feasibility of free-handed conical craniotomy and drainage guided by novel 16-slice mobile CT-assisted surface projection in patients with supratentorial intracerebral hemorrhage (sICH), and to evaluate the accuracy of catheter placement.Methods:Fifty-two sICH patients received free-handed conical craniotomy and drainage guided by novel 16-slice mobile CT-assisted surface projection in our hospital from January 2018 to December 2019 were chosen (free-handed conical craniotomy group); 30 sICH patients received frameless stereotactic puncture and drainage at the same time period were selected (stereotactic puncture group). The clinical data of these patients were retrospectively analyzed. The CT results were analyzed, and differences of relative error (RE) as the indicator of catheter placement accuracy were compared between the two groups.Results:Mobile CT was successfully performed in all patients from free-handed conical craniotomy group, and sufficient information was provided for surface projection in all patients. The percentages of patients with satisfactory results of catheter placement (RE<1) in the free-handed conical craniotomy group and stereotactic puncture group were 92.3% and 90.0%; one patients from the free-handed conical craniotomy group had repeated puncture. There was no significant difference in postoperative RE between the two groups (0.52±0.33 vs. 0.53±0.29, P>0.05). Subgroup analysis of different hematoma locations and volumes also showed no statistically significant difference in postoperative RE ( P>0.05). Conclusion:Free-handed conical craniotomy and drainage guided by novel 16-slice mobile CT-assisted surface projection is feasible in sICH patients, and the accuracy of catheter placement is similar with frameless stereotactic puncture and drainage.
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Objective To discuss the application of self-developed novel 16-slice mobile CT head scan.Methods A total of 391 patients were performed 16-slice mobile CT scan:145 were scanned in the emergency department,156 in the neurosurgical ICU,55 in the operated room,and 35 in the ambulance vehicle.Sixty-eight patients were with brain injury,122 were with cerebral hemorrhage,120 were with cerebral infarction,59 were with brain tumors,and 22 were with hemifacial spasm.Thirty-five patients were randomly selected from 391 patients and 8-slice mobile CT head scan was performed on them,which included 12 with brain injury,6 with cerebral hemorrhage,12 with cerebral infarction,3 with brain tumors and 2 with hemifacial spasm.The resolution,imaging quality,radiation doses,power consumption and performance stability of novel 16-slice mobile CT and 8-slice mobile CT head scan were compared.Results The resolution line pairs of brain tissues were 91 p/cm by 16-slice mobile CT and 71 p/cm by 8-slice mobile CT,respectively.The imaging quality of the two kinds of mobile CT head scans was high level to the clinic diagnostic criteria.The radiation dose of 16-slice mobile CT were 40.43 mGy,which decreased by 51.01％ as compared with that of 8-slice mobile CT (82.52 mGy).The personal power consumption of 16-silce mobile CT (0.29 kW· h) decreased by 38.30％ as compared with those of 8-layer mobile CT (0.47 kW· h).The 16-slice mobile CT kept regularly,while 8-slicer mobile CT stopped to work twice during clinical trial.Conclusion The 16-slice mobile CT scan has high resolution,fine imaging quality,low radiation dose,small power consumption and stable working performance.
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Objective To evaluate and compare the radiation dose and image quality of the new generation of whole body mobile CT (BodyTom CT) with commonly used fixed CT.Methods The image quality was evaluated with CATPHAN 500 performance test body model.The radiation dose was measured by conventional 100 mm pen ionization chamber and PMMA body phantom and head phantom (head diameter 160 mm,phantom diameter 320 rm and width 140 mm).Results The spatial and contrast resolution of BodyTom CT images were similar to two kinds of fixed CT(P ＞ 0.05).The CNR of image with BodyTom CT decreased by about 20％:In head scan mode,significantly lower than that with Philps 64 slice CT and Toshiba 320 slice CT (with soft,t =-4.82,-6.98,P ＜ 0.05;with standard,t =-20.60,-20.09,P ＜0.05);in body scan mode,significantly lower than that with Philps 64 slice CT and Toshiba 320 slice CT (with soft,t =-5.67,-12.82,P ＜ 0.05;with standard,t =-3.39,-9.18,P ＜ 0.05;with sharp,t =-3.88,-3.21,P ＜0.05).The radiation dose with BodyTom CT was significantly higher than that with fixed CT:in body model,22.97％ than that with Philps 64(t=9.48,P＜0.05),29.6％ than that with Toshiba 320 slice CT(t =11.66,P ＜0.05);in head model,29.76％ than that with Philps 64 slice CT(t=23.44,P＜0.05),33.22％ than that with Toshiba 320 slice CT(t=23.11,P＜0.05).Conclusions The radiation dose with mobile CT was over 20％ higher than that with routine multi-row CT while with the similar image quality.
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Objective To identify the spatial distribution of stray radiation from mobile CT head scanning for the purpose of radiation protection.Methods The head series of CareTom mobile CT were scanned and the radiation dose was measured using TLD (LiF:Mg,Cu,P).The isodose maps of radiation dose field were plotted using Matlab software.Results Radiation dose in the front of the mobile CT was slightly higher than that in the back.The maximum value of 0.255 mGy was found to be at 0.5 m from the scanning hole center.Conclusions The stray radiation dose from mobile CT head scanning was relatively low.However in order to avoid the damage to the operators and other medical workers from long-term low dose exposure,it should keep 2 m away from mobile CT,beside or behind,when in operation.
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Objective To compare the scanning frequencies of patients with severe craniocerebral pathological injury with bedside mobile CT (MCT) in neurosurgical intensive care unit (NICU) or with conventional CT (CCT) in Radiology,and investigate the effects of MCT and CCT scanning on secondary cerebral injury and therapeutic results in patients with severe craniocerebral injury.Methods A total of 1917 patients with severe craniocerebral injury,admitted to our hospital from August 2010 to December 2015,under went MCT bedside scanning.And other 593 patients with severe craniocerebral injury were scanned with CCT in radiology.According to Glasgow coma scale (GCS) scores,the patients with severe craniocerebral injury were divided into extra-heavy subgroup (GCS scores:3-5) and heavy subgroup (GCS scores:6-8);the CT scanning frequencies,secondary cerebral pathological damages and Glasgow outcome scale scores 3 months after injury were analyzed and compared.Results The average scanning frequencies of MCT were 5.12 and 4.88 in patients from extra-heavy subgroup and heavy subgroup while the average scanning frequencies of CCT were 3.53 and 4.08 in patients from extra-heavy subgroup and heavy subgroup,with significant differences (P＜ 0.05);patients accepted MCT had significantly higher scanning frequencies than those accepted CCT (P＜0.05).The average scanning frequencies of patients from MCT group were significantly higher than those from CCT group.The incidence of complications was 3.32% and 0％ in extra-heavy subgroup and heavy subgroup from MCT group,respectively;but the incidence of complications was 26.87％ and 18.82％ in extra-heavy subgroup and heavy subgroup from CCT group;significant differences were noted (P＜0.05).GOS showed that the mortality rates (GOS score:1) for the extra-heavy subgroup and heavy subgroup from MCT group were 53.08％ and 17.88％,while those for CCT group were 67.16％ and 26.80％,with significant differences (P＜0.05).The severe disability rates (GOS scores:2-3) for the extra-heavy subgroup and heavy subgroup from MCT group were 21.12％ and 13.48％,while those for CCT group were 26.87％ and 20.72％,with significant differences (P＜0.05).The good recovery rates (GOS scores:4-5) for the extra-heavy subgroup and heavy subgroup from MCT group were 25.12％ and 68.64％,respectively,while those for CCT group were 5.97％ and 52.47％,with significant differences (P＜0.05).Conclusion The operation of MCT bedside scanning is simple,safe and reliable in the NICU,enjoying good clinical effects as compared with CCT scanning.
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PURPOSE: The purpose of this study is to describe the usefulness of intraoperative mobile CT scans in the reduction of zygomatic arch fracture. Method: Two patients with zygomatic arch fractures were selected who were indications of closed reduction by Gilles' approach. After the reduction was done in the operating room with zygomatic arch elevator, intraoperative CT scan was done to check the extent of reduction. Additional reduction was performed according to the obtained images from the intraoperative mobile CT scan. Examination of the preoperative CT, intraoperative CT after the reduction, and postoperative plain X-ray films were done for documentation and analysis. RESULTS: Reduction was carried out successfully to the patients without any complications. Both patients were satisfied with the postoperative cosmetic and functional outcome. Revisional surgery was not necessary during the 6 months follow up. CONCLUSION: The advantage of this method is that it is easier to obtain three dimensional relationships of the fracture site. Furthermore, the operator is less exposed to radiation hazards compared to other methods that obtain intraoperative images such as the C-arm. In conclusion, intraoperative mobile CT scan can be a useful surgical aid in the reduction of zygomatic arch fractures.