Assessment of the Influence of Exposure Parameters on the Diagnostic Quality of Chest Radiographs at National Orthopaedic Hospital, Enugu

Chest radiography is an essential diagnostic tool in the detection and management of cardiopulmonary and thoracic pathologies, especially in orthopaedic settings like the National Orthopaedic Hospital, Enugu (NOHE). The quality of chest radiographs is largely influenced by the appropriate selection of exposure parameters, specifically kilovoltage peak (kVp), milliampere-seconds (mAs), and source-to-image distance (SID). However, the effect of these parameters on image quality at NOHE has not been extensively studied. This study aimed to assess how variations in kVp, mAs, and SID influence the diagnostic quality of chest radiographs performed at NOHE. A descriptive, cross-sectional study was conducted on 200 chest radiographs randomly selected from routine clinical practice. Diagnostic quality was assessed using four indicators: contrast, density, sharpness, and artifacts, all rated on a 5-point Likert scale. The study found that higher kVp (above 110), appropriate mAs (4.0–5.0), and longer SID (>180 cm) were associated with significantly improved contrast, density, sharpness, and fewer artifacts. Multiple regression analysis indicated that kVp and mAs were the strongest predictors of overall image quality. Mismanagement of exposure parameters, such as low kVp with high mAs or excessive SID, significantly decreased image quality and increased the presence of artifacts. The findings emphasize the need for standardizing exposure protocols and enhancing training for radiographers to ensure optimal image quality and minimize patient radiation exposure.