Análise dos parâmetros técnicos aplicados a radiografias de tórax em crianças de 0 a 2 anos, em um hospital infantil

Abstract

This present work describes, under a quality criteria comparative regard, the technical parameters used in pediatric chest radiographs in patients up to 2 years old, in a pediatric Imaging Center and an Intensive Care Unit (ICU) at a Children’s Hospital. As a reference for comparative analysis, the European Guideline on Quality Criteria for Diagnostic Images in Paediatrics (an international benchmark for good practice of pediatric radiology) was selected. Associated with the Guide and the examinations, two age groups and three chest projections were established, ending in four groups of study in two x-ray equipments used: PA/AP 1-24 months and lateral 1-24 months performed with a fluoroscopic equipment of the Imaging Center; AP 1- 24 months and AP in newborns, performed with the mobile equipment in the ICU. The parameters analyzed for the four groups were: exposure time (in ms); radiographic voltage (kV); focus-film distance; focal point size; additional filtration applied; the use or not of an anti-scatter grid; employment of automatic exposure control; the use of protective shielding; collimation; the number of repeated exposures; patient position; radiographic device and immobilization. The results showed that several parameters used in the department are not suited to the European recommendations. However, simple changes in daily practices could change the picture, as well as: use of high kV and low ms technique; cassette in direct contact to the patient, avoiding the use of anti-scatter grid; extinction of fluoroscopic exposure for chest examinations; use of lead protective shielding in patients; proper collimation; chest projections suitable for age group; improved positioning of lateral chest projection and the increase in FFD in the ICU exams.