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Abstract：
In 1971, the first computed tomography (CT) scan was performed on a patient\'s brain. Clinical CT systems were introduced in 1974 and dedicated to head imaging only. New technological developments, broader availability, and the clinical success of CT led to a steady growth in examination numbers. Most frequent indications for non-contrast CT (NCCT) of the head include the assessment of ischemia and stroke, intracranial hemorrhage and trauma, while CT angiography (CTA) has become the standard for first-line cerebrovascular evaluation; however, resulting improvements in patient management and clinical outcomes come at the cost of radiation exposure, increasing the risk for secondary morbidity. Therefore, radiation dose optimization should always be part of technical advancements in CT imaging but how can the dose be optimized? What dose reduction can be achieved without compromising diagnostic value, and what is the potential of the upcoming technologies artificial intelligence and photon counting CT? In this article, we look for answers to these questions by reviewing dose reduction techniques with respect to the major clinical indications of NCCT and CTA of the head, including a brief perspective on what to expect from current and future developments in CT technology with respect to radiation dose optimization.
摘要：
1971年，对患者的大脑进行了首次计算机断层扫描（CT）扫描。临床CT系统于1974年推出，仅用于头部成像。新技术发展,更广泛的可用性，CT的临床成功导致检查数量稳步增长。头部非对比CT（NCCT）最常见的适应症包括评估缺血和中风，颅内出血和外伤,虽然CT血管造影（CTA）已成为一线脑血管评估的标准；然而，患者管理和临床结果的改善是以辐射暴露为代价的，增加继发发病率的风险。因此,辐射剂量优化应该始终是CT成像技术进步的一部分，但是如何优化剂量？在不影响诊断价值的情况下可以实现什么剂量减少，以及即将到来的人工智能和光子计数CT技术的潜力是什么？在这篇文章中，我们通过回顾有关NCCT和头部CTA的主要临床适应症的剂量减少技术来寻找这些问题的答案，包括简要介绍CT技术在辐射剂量优化方面的当前和未来发展。
