Comparison of absorbed radiation doses in barium and air enema reduction of intussusception: a phantom study.

Abstract

We assessed the relative radiation load in patients undergoing hydrostatic and pneumatic reduction of childhood intussusception. In a phantom study we simulated two situations occurring during reduction of intussusception. The absorbed radiation dose was measured at several positions in the phantom using either barium sulphate (BaSO4) or air in the simulated reduction, combined with either automatic exposure control (AEC) or constant exposure rate (CER) at fluoroscopy. From these values the mean absorbed dose was calculated for different depth compartments within the phantom. In the barium study the mean absorbed dose averaged over the total irradiated volume was 14-23 % lower when CER was used instead of AEC; in the air study the dose was 35-43 % lower when AEC was used instead of CER. The combination of air and AEC provided the lowest mean absorbed dose in the tissue. The barium enema created a low-radiation zone, which might be utilized for protecting radiation sensitive tissue. The use of BaSO4 or air in reduction of intussusception requires the proper combination with CER and AEC, respectively, to minimize the radiation load to the patient; the lowest radiation load is obtained by using air and AEC.