複合手術室
Hybrid operating room

context: zh_tw: 複合手術室是一個配備了先進的醫療成像裝置的潔淨手術室：如固定 C 型臂 CT 掃描器或 MRI 掃描器。 這些成像裝置使介入微創手術成為可能。微創是指外科醫生並不需要動刀將病人完全開啟才能接觸到他希望進行手術的身體部分，而是可以透過介入導管或內鏡技術。 雖然移動式 C 臂，超聲內鏡，內鏡檢查的成像技術已經成為手術室的標準組成部分。但介入導管手術需要的成像技術，可以直觀身體的細微部位，例如特別細小的心臟血管，並能透過 3D 成像技術讓手術更易行。
en: A hybrid operating room is a surgical theatre that is equipped with advanced medical imaging devices such as fixed C-Arms, CT scanners or MRI scanners. These imaging devices enable minimally-invasive surgery. Minimally-invasive surgery is intended to be less traumatic for the patient and minimize incisions on the patient and perform surgery procedure through one or several small cuts.
qas: question: zh_tw: 醫院的哪個手術室配備了很多醫療成像裝置？
en: what room has lots of imaging equipment in a hospital?
answers: zh_tw: text: 複合手術室
en: text: hybrid operating room

context: zh_tw: 對病變的心臟瓣膜的修復和心律失常和主動脈瘤的手術治療可以受益於複合手術室的成像能力。心臟複合（雜交）手術是針對這些疾病的普遍治療方式。
en: The repair of diseased heart valves and the surgical treatment of rhythm disturbances and aortic aneurysms can benefit from the imaging capabilities of a hybrid OR. Hybrid Cardiac Surgery is a widespread treatment for these diseases.
qas: question: zh_tw: 複合手術室有什麼能力？
en: What does a hybrid OR provide?
answers: zh_tw: text: 成像能力
en: text: imaging capabilities

context: zh_tw: 並且，腹主動脈瘤的腔內治療技術的發展，推動了血管造影系統在血管手術環境中的應用。  特別是對於複雜的血管腔內移植物，複合手術室應成為基本條件。同時，它也很適用於急診手術治療。有些外科醫生不止認可外科手術進行時的血管腔內移植物，他們同時也使用血管造影系統和應用程式為手術做計劃與引導。由於患者在術前 CT 和術中透視的解剖位置改變，以及嵌入的堅硬材料而導致的改變，對術中更精準的規劃設計提出了相應要求，如果外科醫生在手術進行時運用旋轉血管造影術，能對主動脈採用自動分割，對腎動脈和其他位置進行 3D 標記，然後覆蓋二維透視疊加，並且能隨著 C 型臂角度 / 位置或手術床的變化而進行更新。
en: Also, the shift towards endovascular treatment of abdominal aortic aneurysms pushed the spread of angiographic systems in vascular OR environments. Particularly for complex endografts, a hybrid operating theater should be a basic requirement. Also, it is well-suited for emergency treatment.Some surgeons do not only verify the placement of complex endografts intraoperatively, they also use their angiography system and the applications it offers for planning the procedure. As anatomy changes between a preoperative CT and intraoperative fluoroscopy because of patient positioning and the insertion of stiff material, a much more precise planning is possible if the surgeon performs an intraoperative rotational angiography, takes an automatic segmentation of the aorta, places markers for the renal arteries and other landmarks in 3D and then overlays the contours on 2D fluoroscopy. This guidance is updated with any change in C-Arm angulation/position or table position.
qas: question: zh_tw: 對於腹主動脈瘤方面的治療，現時的進展如何？
en: where has treatment been headed when it comes to abdominal aortic aneurysms?
answers: zh_tw: text: 血管手術
en: text: endovascular treatment

context: zh_tw: 電視胸腔鏡手術（VATS）是用一種可避免開胸的微創技術切除肺結節的微創手術。利用胸腔鏡喬卡，將光源，攝像頭，和手術器械進入胸腔進行肺結節等組織切除。雖然這種型別的微創手術可提高患者的恢復速度和並減少潛在的併發症，但視野和觸感確實使得醫生很定位肺小結節，特別是在非表層腫瘤，毛玻璃樣變，和微小病變的情況下難度更大。研究顯示小於 1 釐米的結節，其檢出率低於 40％。 因此有時健康的組織比實際需要切除的組織要多，以避免腫瘤殘餘。在手術室採用先進的手術成像有助於精確定位和切除病灶，避免潛在的組織損傷，加快手術流程。在放置喬卡之前也就是在肺葉可能發生塌陷之前，旋轉採集造影可以更好的為 VATS 提供影像學引導。這樣損傷就能在不用造影劑的情況下看到了。然後，勾型針或造影劑（碘油，碘帕醇 ）被引導至病變處，或臨近病變，以確保肺萎陷後血管造影的可視性。然後開始常規胸腔鏡的步驟。此時使用的成像系統，在透視模式下，可以清楚地看到腔鏡器械和先前標記的病變。使得精準的切除成為可能。造影劑可以被用來標記病變，同樣也可以標記處附近區域淋巴結，並且使用同樣的方式去切除淋巴結。
en: VATS (video-assisted thoracoscopic surgery) is a minimally-invasive technique to resect lung nodules that saves the patient the trauma of a thoracotomy. Thereby, small ports are used to access the pulmonary lobes and introduce a camera on a thoracoscope, along with the necessary instruments. While this procedure speeds up recovery and potentially reduces complications, the loss of natural vision and tactile sensing makes it difficult for the surgeon to locate the nodules, especially in cases of non-superficial, ground-glass opaque, and small lesions. The yield rate for nodules < 1 cm can be below 40% as studies show. As a consequence sometimes more healthy tissue is resected than actually necessary in order to avoid missing (parts of) the lesion. Using advanced intra-operative imaging in the OR helps to precisely locate and resect the lesion in a potentially tissue-sparing and quick fashion. In order to be able to use image guidance during VATS, rotational angiography has to be performed before the introduction of ports, thus before the lobe in question deflates. This way the lesion is visible through the natural contrast of air. In a second step, hook wires, thread needles, or contrast agent (Lipiodol, Iopamidol) are introduced into or next to the lesion to ensure visibility on the angiogram after lung deflation. Then, the conventional part of VATS starts with the introduction of thoracoscopes. The imaging system is used in fluoroscopic mode now, where both the inserted instruments and the previously marked lesion are well visible. A precise resection is now possible. In case contrast agent has been used to mark the lesion, it will also drain into the regional lymph nodes, which then can be resected within the same procedure.
qas: question: zh_tw: 成像系統被用在哪裡？
en: Where is the imagining system used?
answers: zh_tw: text: 透視模式
en: text: fluoroscopic mode

context: zh_tw: 外科醫生所面臨的挑戰是自然損失的 3D 視覺和觸覺感測。透過內窺鏡提供的影象，無法感受到組織。在複合手術室裡可以更新和實時成像。3D 影象可以融合以及 / 或者重疊顯示在 X 線透視或內窺鏡中。在腹腔鏡肝臟手術中 (實時影象指導：根據術中 CT 成像制導系統的臨床經驗。) 關鍵解剖血管或腫瘤可以避免和減少併發症。進一步的調查受到審判。(在泌尿外科手術導航。歐洲的視角)
en: As in other minimally invasive surgery the first laparoscopic surgeons were smiled at and the surgical community did not believe in this new technology. Today it is the gold standard for most surgeries. Starting with a simple appendectomy, partial kidney resections and partial liver resections, etc. The laparoscopic approach is expanding. The image quality, the possibility of imaging the patient in the surgical position and the guidance of the instruments facilitate this approach.(Efficacy of DynaCT for surgical navigation during complex laparoscopic surgery: an initial experience. Partial resection of the kidney, leaving as much healthy tissue, meaning kidney function to the patient has been described some time ago (Nephron sparing surgery for renal tumors: indications, techniques and outcomes.). The challenges the surgeons face is the loss of natural 3D vision and tactile sensing. Through small ports he/she has to rely on the images provided by the endoscope and is unable to feel the tissue. In a hybrid operating room the anatomy can be updated and imaged in real time. 3D images can be fused and/or overlaid on live fluoroscopy or the endoscope. (Real-time image guidance in laparoscopic liver surgery: first clinical experience with a guidance system based on intraoperative CT imaging.) Crucial anatomy like vessels or a tumor can be avoided and complications reduced. Further investigations are under trial at the moment. (Surgical navigation in urology. European perspective)
qas: question: zh_tw: 外科醫生經內窺鏡進行手術時，缺乏什麼型別的視覺？
en: What type of vision surgeons lack when operating via endoscope?
answers: zh_tw: text: 3D 視覺
en: text: 3D vision

context: zh_tw: 旋轉血管造影是一種採用固定 C 型臂術中採集類 CT 和 3D 影像的技術。要做到這一點，在 C 型臂圍繞患者旋轉，取得一系列的資料並用來進行 3D 重建。
en: Rotational angiography is a technique to acquire CT-like 3D images intraoperatively with a fixed C-Arm. To do that, the C-Arm is rotated around the patient, acquiring a series of projections that will be reconstructed to a 3D data set.
qas: question: zh_tw: 旋轉血管造影採用什麼型的臂？
en: Rotational angiography uses what kind of arm?
answers: zh_tw: text: C 型臂
en: text: C-Arm

context: zh_tw: 將工作站的資訊新增到透檢視像的另一種可供選擇的方法是疊加，可以在疊加三維影象的透檢視像上對感興趣結構的部分進行手動或自動分割，勾畫標記輪廓。這為透檢視像提供了額外的資訊。有些應用軟體可以自動標記，也可以讓醫生和技師手動新增標記點。舉個病例：了給一個腹主動脈瘤放置一個開窗的覆膜支架，在 3D 影象上標記腎動脈開口，然後將標記的 3D 影象疊加在實時透檢視像上。在 3D 標記完成後，它會與實時透檢視像自動匹配，讓醫生可以在實時透檢視像始終觀察到標記好的腎動脈開口，從而讓開窗支架準確定位。
en: additional information which is not visible in the fluoroscopic image. Some software available provides landmarks automatically, more can be added manually be the surgeon or a qualified technician. One example is the placement of a fenestrated stentgraft to treat an abdominal aortic aneurysm. The ostia of the renal arteries can be circled on the 3D image and then overlaid on the live fluorscopy. As the marking has been done in 3D, it will update with any change of the fluoroscopy angulation to match the current view.
qas: question: zh_tw: 誰可在軟體手動新增標記點？
en: Who can manually add landmarks to the software?
answers: zh_tw: text: 醫生和技師
en: text: surgeon or a qualified technician

context: zh_tw: 術後評估結果 MRI 系統一般需要一個很大的空間，無論是在房間和病人的周圍。在常規 MRI 室進行手術是不可能的。在術中如何使用 MR 有兩種方法，一種是當需要成像時，一個可移動的磁共振掃描器被移動到手術區域，另一種是在手術過程中把病人運送到臨近有磁共振掃描器的房間。
en: After surgery to evaluate the outcomeAn MRT system usually requires a lot of space both in the room and around the patient. It is not possible to perform surgery in a regular MRT room. Thus for step 2, there are two solutions of how to use an MR interoperatively, one is a moveable MRT scanner that can be brought in only when imaging is needed, the other is to transport the patient to an MR scanner in an adjacent room during surgery.
qas: question: zh_tw: 什麼評估手術後的結果？
en: What evaluates the outcome after surgery?
answers: zh_tw: text: MRI 系統
en: text: An MRT system

context: zh_tw: 不僅複合手術室的使用率是一個 “複合” 的，它在醫院系統的角色也是複合的。由於它有影像系統，放射科因對操作、技術、維護、和連線有專業知識，所以放射科對手術室房間負主要責任。從患者工作流程來看，這個房間要能被外科部門所使用，而且應該被安裝在其他手術設施的旁邊，以確保患者適當治療和快速轉運。
en: Not only the usage of a hybrid operating room is "hybrid", but also its role within the hospital system. As it holds an imaging modality, the radiology department could take the lead responsibility for the room for expertise in handling, technical, maintenance, and connectivity reasons. From a patient workflow perspective, the room could be run by their surgical department and should rather be situated next to other surgical facilities, to ensure proper patient care and fast transportation.
qas: question: zh_tw: 放射科能夠承擔哪些責任？
en: What are the responsibilities  radiology could shoulder?
answers: zh_tw: text: 操作、技術、維護、和連線
en: text: handling, technical, maintenance, and connectivity reasons

context: zh_tw: 對於標準的醫院房間大小安裝複合手術室是一大挑戰，因為不僅成像系統需要一些額外的空間，而且一個正規的手術有更多的人在房間裡。一個 8 至 20 人的工作團隊，其中包括麻醉醫生，外科醫生，護士，放射技師，體外迴圈師，從裝置公司來的支援人員等能在這樣一個手術室工作。根據所選擇的成像系統，建議房間面積為 70 平方米，包括一間控制室，但不包括裝置間和準備區。房間所必須的額外準備工作是 2-3mm 的鉛防護，安裝影像系統額外增加在地板上或天花板上的重量（約 650-1800 千克）。
en: Installing a hybrid OR is a challenge to standard hospital room sizes, as not only the imaging system requires some additional space, but there are also more people in the room as in a normal OR. A team of 8 to 20 people including anasthesiologists, surgeons, nurses, technicians, perfusionists, support staff from device companies etc. can work in such an OR. Depending on the imaging system chosen, a room size of 70 square meters including a control room but excluding a technical room and the preparation areas is recommended. Additional preparations of the room necessary are 2-3mm lead shielding and potentially enforcement of the floor or ceiling to hold the additional weight of the imaging system (approximately 650–1800 kg).
qas: question: zh_tw: 通常有多少人在 OR 裡工作？
en: How many people usually work in the OR?
answers: zh_tw: text: 8 至 20 人
en: text: 8 to 20 people

question: zh_tw: 團隊推薦什麼？
en: What was recommended of the team?
answers: zh_tw: text: 建議房間面積為 70 平方米，包括一間控制室，但不包括裝置間和準備區
en: text: a room size of 70 square meters including a control room but excluding a technical room and the preparation areas

context: zh_tw: 在一般情況下，兩個不同的光源需要在手術室：用於手術的無影燈和可支援介入的環境照明。應特別注意的是可提供昏暗的燈光，因為經常需要在 X 線透視或內鏡檢查。對於手術燈，最重要的是完整的覆蓋整個手術室操作檯。更重要的是，不得干預頭的高度以及與其他裝置路徑相碰撞。最常見的手術燈的安裝位置是手術檯正上方。如果選擇不同的位置，手術燈要可以在手術床的外圍區域旋轉。因為每個手術燈前端的中心軸是必要的，這可能會導致至少兩個中心軸和安裝點，以確保手術區域有足夠的照明。血管造影系統的移動範圍決定了手術燈的位置。中央軸必須在移動路徑和旋轉範圍之外。裝置決定了房間高度，這個要求必然 要面對，這非常重要。在這種情況下，頭部淨空高度可能是一個問題。這使得手術燈在規劃和設計過程中是一個關鍵的專案。 在手術燈規劃過程中的其他方面包括避免燈光的刺眼和反射。現代手術燈會有額外的功能，如照相和攝像功能。為了傷口區域的照明，雙臂手術光系統是必需的。有時甚至需要第三個手術燈，如在同時進行一項以上的外科手術操作的情況下，例如大腿的靜脈剝離。綜上所述，手術燈系統規劃的主要關鍵點包括：
en: In general, two different light sources are needed in an operating room: the surgical (operating) lights used for open procedures and the ambient lighting for interventional procedures. Particular attention should be paid to the possibility to dim the lights. This is frequently needed during fluoroscopy or endoscopy. For the surgical lights it is most important that they cover the complete area across the operating room table. Moreover, they must not interfere with head heights and collision paths of other equipment. The most frequent mounting position of OR-lights is centrally above the OR table. If a different position is chosen, the lights usually are swivelled in from an area outside the OR table. Because one central axis per light head is necessary, this may lead to at least two central axes and mounting points in order to ensure sufficient illumination of the surgical field. The movement range of the angiography system determines the positioning of the OR lights. Central axes must be outside of moving path and swivel range. This is especially important as devices have defined room height requirements that must be met. In this case, head clearance height for the OR-light may be an issue. This makes lights a critical item in the planning and design process. Other aspects in the planning process of OR lights include avoidance of glare and reflections. Modern OR lights may have additional features, like build in camera and video capabilities. For the illumination of the wound area, a double-arm OR-light system is required. Sometimes even a third light may be required, in cases where more than one surgical activity takes place at the same time, e.g. vein stripping of the legs.
qas: question: zh_tw: 手術燈光安裝最普遍的地方是哪裡？
en: What is the most common place to mount operating room lights?
answers: zh_tw: text: 手術檯正上方
en: text: centrally above the OR table

question: zh_tw: 對於手術燈位置來說，重要的是什麼？
en: What is important about the position of OR-lights?
answers: zh_tw: text: 不得干預頭的高度以及與其他裝置路徑相碰撞
en: text: they must not interfere with head heights and collision paths of other equipment

context: zh_tw: 最常見的影像形式，是安裝在複合手術室中的一個大 C 型臂。專家一致認為在複合手術室移動式 C 臂的效能是不足的，因為球管有限的功率影響了成像質量，影像增強器的視野小於平板探測器系統的，以及移動式 C 臂的冷卻系統可能在數小時後就導致過熱，這對於漫長的外科手術過程或一系列複雜的手術而言時間太短了。而這樣一間配備移動式 C 臂手術室的投資也是很高的。  固定 C 型臂沒有那些侷限性，但房間裡需要更多的空間。這些系統可被安裝在地板上，或在天花板上，如果選擇雙板系統可兩者兼而有之。如果是兒科心臟病專家，電生理學家或神經介入專家主要使用這個房間，會選擇後者。如果不是這些臨床學科明確要求，安裝雙板系統一般不推薦，因為安裝在天花板上的部件可能引起潔淨度問題： 實際上，大部分醫院不會允許操作部件在手術區域的正上方，因為灰塵可能落入傷口而引起感染。因為任何懸吊系統都包括了手術區域上方的可移動部件，會削弱層流，這樣的系統對於肯定不是執行最高潔淨度標準的醫院最佳選擇。（見  僅德文）
en: The most common imaging modality to be used in hybrid ORs is a C-Arm. Expert consensus rates the performance of mobile C-arms in hybrid ORs as insufficient, because the limited power of the tube impacts image quality, the field of view is smaller for image-intensifier systems than for flat-panel detector systems and the cooling system of mobile C-Arms can lead to overheating after just a few hours, which can be too short for lengthy surgical procedures or for multiple procedures in a row, that would be needed to recover the investment in such a room.Fixed C-Arms do not have these limitations, but require more space in the room. These systems can be mounted either on the floor, the ceiling, or both if a biplane system is chosen. The latter is the system of choice if pediatric cardiologists, electrophysiologists or neurointerventionalists are major users of the room. It is not recommended to implement a biplane system if not clearly required by these clinical disciplines, as ceiling-mounted components may raise hygienic issues: In fact, some hospitals do not allow operating parts directly above the surgical field, because dust may fall in the wound and cause infection. Since any ceiling-mounted system includes moving parts above the surgical field and impairs the laminar airflow, such systems are not the right option for hospitals enforcing highest hygienic standards. (see also and, both German only)
qas: question: zh_tw: C 型臂可以安裝在什麼位置？
en: What location can C-arms be mounted to?
answers: zh_tw: text: 在地板上，或在天花板上，如果選擇雙板系統可兩者兼而有之
en: text: the floor, the ceiling, or both

context: zh_tw: 在決定懸吊系統和落地系統時，還有更多的因素要考慮。懸吊系統需要大量的頂部空間，因此，減少了手術燈或吊臂安裝的位置。儘管如此，許多醫院選擇懸吊系統具有更大的靈活性，能覆蓋全身 ， 最重要的 是不移動手術床。在手術期間移動手術床有時是困難和危險的工作，因為連著喝多的導線及導管也必須被移動。然而，在手術過程中從停機位到工作位的移動，用落地式系統更容易，因為 C 型臂只是從側面轉動，並且不會干擾麻醉師。相比之下，懸吊系統在手術過程中能幾乎不用移動在頭端的停機位，也就不會碰撞麻醉裝置。在一個像手術室一樣擁擠的環境裡，雙板系統增加了其複雜性並干擾麻醉，除了神經外科，神經外科的麻醉不是在頭端端。因此，主要用於心臟手術的房間無疑推薦單板系統。
en: There are more factors to consider when deciding between ceiling- and floor-mounted systems. Ceiling-mounted systems require substantial ceiling space and, therefore, reduce the options to install surgical lights or booms. Nonetheless, many hospitals choose ceiling-mounted systems because they cover the whole body with more flexibility and – most importantly – without moving the table. The latter is sometimes a difficult and dangerous undertaking during surgery with the many lines and catheters that must also be moved. Moving from a parking to a working position during surgery, however, is easier with a floor-mounted system, because the C-arm just turns in from the side and does not interfere with the anesthesiologist. The ceiling-mounted system, by contrast, during surgery can hardly move to a parking position at the head end without colliding with anesthesia equipment. In an overcrowded environment like the OR, biplane systems add to the complexity and interfere with anesthesia, except for neurosurgery, where anesthesia is not at the head end. Monoplane systems are therefore clearly recommended for rooms mainly used for cardiac surgery.
qas: question: zh_tw: 是什麼讓手術過程中移動手術床變得更容易？
en: What makes changing positions during surgery less difficult?
answers: zh_tw: text: 落地式系統
en: text: a floor-mounted system

question: zh_tw: 麻醉裝置是如何擺放的？
en: how are the anasthesia equipement placed?
answers: zh_tw: text: 懸吊系統
en: text: ceiling-mounted system

context: zh_tw: 在手術室有幾個簡單的措施來保護人員免受散開輻射，從而降低他們受的劑量。意識是一個關鍵的問題，否則可用的保護工具可能被忽視。這些工具中有為軀幹形成防護罩的防護衣，圍繞頸部保護甲狀腺區域的防護盾以及鉛防護眼鏡。可以在床邊安裝額外的鉛裙，保護下體部位。懷孕的工作人員應適用更嚴格的規則。
qas: question: zh_tw: 根據本文的說法，鉛放在桌邊時有什麼作用？
en: What does lead do when placed on the table side according to this text?
answers: zh_tw: text: 保護下體部位

context: zh_tw: 當然，對工作人員和病人都保護的一個非常有效的措施是運用更少的輻射。總有一個輻射劑量和影象質量之間的權衡。更高的 X 射線劑量會導致一個更清晰的畫面。現代軟體技術通過後處理過程可以提高影象質量，這樣，用較低的劑量就可以達到相同的影象質量。影象質量可以透過對比度，信噪比，解析度和偽影等幾個指標來評判。總之，應遵循 ALARA 原則（合理抑低）。劑量應儘可能低，但權衡影象質量對檢查診斷的保證及劑量對病人的潛在危害時仍應首先保證影象質量。
en: X-ray radiation is ionizing radiation, thus exposure is potentially harmful. Compared to a mobile C-Arm, which is classically used in surgery, CT scanners and fixed C-Arms work on a much higher energy level, which induces higher dose. Therefore, it is very important to monitor radiation dose applied in a hybrid OR both for the patient and the medical staff.There are a few simple measures to protect people in the OR from scatter radiation, thus lower their dose. Awareness is one critical issue, otherwise the available protection tools might be neglected. Among these tools is protective clothing in the form of a protective apron for the trunk, a protective thyroid shield around the neck and protective glasses. The later may be replaced by a ceiling-suspended lead glass panel. Additional lead curtains can be installed at the table side to protect the lower body region. Even more restrictive rules apply to pregnant staff members.A very effective measure of both protection to both the staff and the patient of course is applying less radiation. There is always a trade-off between radiation dose and image quality. A higher x-ray dose leads to a clearer picture. Modern software technology can improve image quality during post-processing, such that the same image quality is reached with a lower dose. Image quality thereby is described by contrast, noise, resolution and artifacts. In general, the ALARA principle (as low as reasonably achievable) should be followed. Dose should be as low as possible, but image quality can only be reduced to the level that the diagnostic benefit of the examination is still higher than the potential harm to the patient.
qas: question: zh_tw: 什麼應該比造成病人傷害的風險的地位更高？
en: What should be kept at a higher level than the risk of injury to the patient?
answers: zh_tw: text: 影象質量對檢查診斷的保證
en: text: diagnostic benefit

question: zh_tw: 什麼是 X 射線的權衡？
en: What are the trade off of X-ray?
answers: zh_tw: text: 輻射劑量
en: text: radiation dose

question: zh_tw: 根據本文的說法，鉛放在桌邊時有什麼作用？
answers: en: text: protect the lower body region

context: zh_tw: 射線準直器是降低劑量的另一種工具。從探測器的角度來講，只有一小部分用於介入診療。透過準直器可以濾過 X 線球管的多餘射線，因此探測器只接受了穿過做檢查的組織結構的射線劑量。如今的大 C 臂能夠在非透視條件下透過採集的影象做診療。
en: Beam Hardening: X-ray radiation consists of hard and soft particles, i.e. particles with a lot of energy and particles with little energy. Unnecessary exposure is mostly caused by soft particles, as they are to weak to pass through the body and interact with it. Hard particles, by contrast, pass through the patient. A filter in front of the x-ray tube can catch the soft particles, thus hardening the beam. This decreases dose without impacting image quality.Frame rate: High frame rates (i.e. images acquired per second) are needed to visualize fast motion without stroboscopic effects. However, the higher the frame rate, the higher the radiation dose. Therefore, the frame rate should be chosen according to the clinical need and be as low as reasonably possible. For example, in pediatric cardiology, frame rates of 60 pulses per second are required compared to 0.5 p/s for slowly moving objects. A reduction to half pulse rate reduces dose by about half. The reduction from 30 p/s to 7.5 p/s results in a dose saving of 75%.When using pulsed fluoroscopy, radiation dose is only applied in prespecified intervals of time, thus less dose is used to produce the same image sequence. For the time in between, the last image stored is displayed.Another tool for decreasing dose is collimation. It may be that from the field of view provided by the detector, only a small part is interesting for the intervention. The x-ray tube can be shielded at the parts that are not necessary to be visible by a collimator, thus only sending dose to the detector for the body parts in question. Modern C-Arms enable to navigate on acquired images without constant fluoroscopy.
qas: question: zh_tw: 什麼提供了視野？
en: What provides a field of view?
answers: zh_tw: text: 探測器
en: text: the detector