Grids

A grid has the main purpose of increasing radiographic contrast by absorbing Compton
scatter through the utilization of lead strips strategically placed. Grids are used in exams of a
body part greater than 10 cm, or when kVp is greater than 60. If a grid is not available then it is
possible to use an air gap technique, which is increasing OID and in turn increasing SID to
reduce the magnification that is caused with OID. For every centimeter of air gap there needs to
be a 10% increase in mAs. 10-15 cm of air gap is equivalent to an 8:1 grid ratio; a 10 inch air
gap is equivalent to a 15:1 grid ratio.

To make a grid that can be utilized for radiographic images there has to be lead strips
alternating with interspace composed of aluminum and/or plastic. The dimensions and placement
of the lead strips and the space between them is essential. They are categorized using grid ratios,
which are calculated by dividing the height of the lead strip by the width that exists between
them. The amount of mAs that is needed changes with each grid ratio, the grid conversion factor
was created to compensate for the changes that may need to take place. The grid conversion
factor is:

mAs1/mAs2 = GCF1/GCF2

The following factors are used when applying the grid conversion factor:

Grid Ratio Grid Conversion Factor

No grid 1
5:1 grid 2
6:1 grid 3
8:1 grid 4
12:1 grid 5
16:1 grid 6

Grid frequency is the number of lead lines per inch. These two factors affect how much
scatter radiation will be absorbed, as well as how the photons will reach the receptor, the more
lead there is the more scatter will be absorbed. The lead strips can be placed in different patterns.
Demonstrated below there is a linear grid pattern, as well as a criss-cross pattern grid.
 The criss-cross pattern is not widely used, this is because there cannot be any angulation
on the tube or else there will be a result of grid cut-off. The linear pattern is used much more
frequently because the x-ray tube can be angled along the lines of the grid without interrupting
the primary beam. Of the linear grids there are different types; there are parallel grids and
focused grids.

In a parallel grid the lead lines will never intersect each other, as shown above the SID on
a parallel grid is important, at longer distances more primary beam will be able to pass through
without being interrupted by the lead. The shorter the distance used the more cut-off there will be
along the edges of the right and left sides.

More commonly used are focused grids; focused grids are more complex, in that the lead
lines are slightly angled more and more from the center of the grid out. This is done to match the
divergence of the beam. Each of the lead lines, if extended, will meet at a point known as the
convergence line. Focused grids are used more frequently; they allow more of the primary beam
to reach the image receptor, while effectively absorbing scattered radiation.
 Many things can go wrong when grids are improperly used. There are five main errors
that may occur when a grid is improperly used, off-level, off-center, off-focus, upside down
grids, and the moire effect.

If the tube is angled across the axis of the grid then there will be off-level grid error, this
also occurs if a grid is angled. It is important to only angle the tube along the long axis;
otherwise it must be perpendicular to the grid. Some examples of this happening is if a patients
weight curves the grid, or if a portable exam is done and the grid is tilted. If the grid is not level
with the tube then the primary beam will be absorbed more, causing the image to look
underexposed. This will occur with all of the different types of grids.

Off-center errors occur when the tube is not lined up with the center of a focused grid.
Because a focused grids lead lines are angled with the divergence of the beam it is essential to
line the tube with the center of the grid, if this is not achieved then the lead lines will inhibit most
of the primary beam from reaching the receptor, causing the image to look underexposed. This
occurs with focused grids, a parallel grid will not have the same error because the lead lines do
not angle, allowing the photons to pass through.

In an off-focus error the tube is either too far away, or too close to the receptor. Grids are
designed for specific distances in order to be most effective, if these distances are not used then
cutoff will occur.

A grid can sometimes be used upside down, this causes severe cutoff, and almost all of
the photons will be absorbed, resulting in only small amounts reaching the IR through the
centermost lead strips. This is because of the angulation of the lead lines as shown above, as is
only experienced with focused grids.
 The Moire effect is the last error that can occur; this occurs using digital receptors when
stationary exams are done. The lead lines are read in the same direction as the movement of the
laser reading the image plate, (Adler, 2013). This is seen on an image as many small lines
running through it and can be avoided by using high frequency grids with a stationary grid. This
does not happen with moving grids because the movements are either perpendicular to the grid
lines or oscillating.
 References

Adler, A.M. & Carlton, R.R. (2013). Principles of radiographic imaging an art and a science
(5th ed). Cengage Learning: Clifton Park, NY.