To use a spiral CT effectively, it's essential to take a comprehensive approach from the initial installation through daily operations. Implementing rationalization measures ensures the machine functions in an optimal environment and that operators have a clear understanding of its principles. This not only enhances the machine's performance but also helps reduce operational costs over time.
In recent years, spiral CT has become widely available across hospitals at all levels, significantly improving diagnostic accuracy and imaging quality, and laying a solid foundation for clinical practice. However, despite its rapid adoption, many hospitals—especially those at the district and county levels—still face challenges in using these machines efficiently. Issues such as improper operation, lack of proper training from manufacturers, and insufficient maintenance lead to increased wear and tear, higher failure rates, and greater expenses. Therefore, it is crucial for CT users to understand the working principles and characteristics of their equipment and continuously refine their practical experience to keep the machine in top condition.
Most spiral CT systems in our city were installed after 2000. Based on my experience with their usage, I would like to share some practical tips for better operation and maintenance.
1. Room Selection and Installation Requirements
The CT room should be located in an area with minimal vibration, no strong electromagnetic interference, low noise, and clean air. It should ideally be close to the power distribution room and easily accessible for patients and technicians. The layout must ensure safety, allow for maintenance, and provide smooth patient flow. Additionally, it’s important to separate different work areas such as the control panel, power supply, workstations, and other supporting equipment to minimize interference.
Cable installation should avoid AC electromagnetic fields like transformers and motors. Signal and power cables should be shielded and properly routed. If necessary, a sealed trench lined with galvanized steel can be used to protect against rodents and damage. Long cables should be coiled rather than folded or looped to prevent signal loss.
A UPS (uninterruptible power supply) is highly recommended for the system computer to prevent data loss due to sudden power outages. The main power supply capacity should be at least 10–20% higher than the total rated power of the CT unit. A good grounding system is essential, with resistance less than 2Ω, and it should be checked every six months. Grounding connections to metal parts should have a resistance of less than 0.1Ω.
2. Preheating After Startup
Before scanning the first patient, the machine must be fully preheated. This ensures the X-ray tube filament is sufficiently heated, preventing damage during the scan. It also helps maintain image quality by allowing the circuits to stabilize before operation.
3. Maintain Cleanliness
Daily cleaning of the machine room and internal components is essential. Dust accumulation can affect heat dissipation and increase the risk of circuit failures. Keeping the slip ring and carbon brush free from dust reduces friction and prolongs their lifespan. Good ventilation is also key to maintaining the system's stability.
4. Regular Inspection of Consumables
Components like the slip ring and carbon brush require regular maintenance. After every 5,000 scans or 400,000 rotations, the slip ring should be cleaned, and the carbon brush inspected for wear. Replacement marks are usually engraved on the brushes, and they should be replaced when worn or near the mark to avoid damaging the slip ring. Lubrication of rotating parts should also be checked regularly.
5. Timely Start and End of Scans
When the machine is ready for spiral scanning, the gantry rotates continuously at high speed. At this point, the X-ray tube filament is fully heated, and the system gives visual and keyboard prompts. Operators should initiate the scan promptly to avoid unnecessary wear on the slip ring and carbon brush, as well as excessive heating of the filament. Once the scan is complete, the machine should exit the scanning mode, returning the filament to a preheated state and stopping the slip ring rotation. This helps extend the life of the components and keeps the ratio of slip ring rotations to tube exposures within 10:1, if possible.
Understanding this principle, operators should carefully review each scan request, plan the procedure accordingly, and position the scan accurately. Avoiding unnecessary pauses and re-scans, especially in breathing-affected areas, can reduce machine downtime and improve efficiency. It’s also important for radiologists to take responsibility for both diagnosis and scanning techniques, breaking away from traditional roles where only technicians handled scans. When doctors perform scans themselves, they can better detect lesions, minimize radiation exposure, reduce costs, and protect the machine from unnecessary strain.
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