primerjava kakovosti slike in dozne obremenitve
Šejla Trožić (Avtor), Damijan Škrk (Recenzent), Nejc Mekiš (Mentor), Andrew England (Komentor)

Povzetek

Uvod: Najpogosteje uporabljena radiografska projekcija pri slikanju medenice in kolkov je AP projekcija v ležečem položaju, vendar nekateri menijo, da bi bilo bolje izvajati slikanje medenice stoje, saj bi s tem dobili diagnostično bolj uporabne informacije. V predhodni študiji, kjer so primerjali AP slikanje medenice stoje in leže pa so poročali o višji dozi in slabši kakovosti rentgenogramov pri slikanju medenice stoje. Namen: Namen raziskave je bil ugotoviti, ali se kakovost rentgenogramov in prejeta doza razlikujeta pri dveh različnih načinih slikanja medenice stoje - z odmikom in brez odmika mehkega tkiva. Metode dela: Meritve so bile razdeljene na dva dela. Prvi del je obsegal študijo na fantomu, kjer smo izbrali trak, ki ni povzročal vidnih artefaktov na rentgenogramu. S tem trakom so si pacienti v drugem delu študije umaknili tkivo s področja slikanja. Drugi del študije je bil izveden na 60-ih pacientih, ki so bili napoteni na rentgensko slikanje medenice stoje. Bili so naključno razdeljeni v dve skupini z enakim številom. Polovica jih je umaknila tkivo s področja slikanja, druga polovica pa ne. Pri vseh smo izmerili obseg pasu in bokov, telesno višino in maso, DAP, velikost polja, razdaljo med goriščem in objektom slikanja, tokovni sunek (mAs) in napetost (kV). Naknadno smo iz meritev še izračunali indeks telesne mase, vstopno kožno dozo in efektivno dozo. Dobljene slike so ocenili trije radiologi. Rezultati: V prvem delu raziskave smo ugotovili, da tanka trikotna ruta ne povzroča artefaktov na rentgenogramu. Opazili smo statistično značilne razlike v obsegu pasu pred in po umiku mehkega tkiva (p<0.001), saj se je le-ta zmanjšal za 4.7%. Pri obsegu bokov pred in po umiku tkiva ni bilo statistično značilnih razlik (p=0.211). DAP je bil za 38.5% nižji v skupini pacientov, ki so umaknili tkivo med preiskavo (p=0.001). Prav tako je bila tudi vstopna kožna doza nižja v omenjeni skupini pacientov, in sicer za 44% (p<0.001). Efektivna doza se je znižala za 38.7% pri tistih, ki so umaknili tkivo s področja slikanja (p<0.001). Kolčna sklepa (p=0.001), trochantri (p=0.021), acetabulum (p<0.001), vratova stegnenice (p=0.021), medula in korteks medenice (p=0.009), križnica in križnične odprtine (p=0.008) ter mehka tkiva medenice in kolkov (p=0.039) so bili bolj vidni na slikah z odmikom mehkega tkiva. Statistično značilnih razlik med skupinama pacientov nismo našli pri prikazu sakroiliakalnih sklepov (p=0.055), črevničnih grebenov (p=0.060) in vej sramnice in sednice (p=0.166). Skupna ocena slik je bila višja v skupini z odmikom mehkega tkiva (p=0.004). Razprava in zaključek: Ugotovili smo, da se pri slikanju medenice stoje z odmikom maščobnega tkiva znižajo DAP, vstopna kožna doza in efektivna doza, hkrati pa se izboljša tudi kakovost slike, saj z odmikanjem mehkega tkiva s področja slikanja postajajo bolj vidne anatomske strukture medenice in kolkov.

Ključne besede

master's theses;radiologic technology;erect pelvic radiography;fat tissue removal;image quality;radiation dose;

Podatki

Jezik: Angleški jezik
Leto izida:
Tipologija: 2.09 - Magistrsko delo
Organizacija: UL ZF - Zdravstvena fakulteta
Založnik: [Š. Trožić]
UDK: 616-07
COBISS: 76739331 Povezava se bo odprla v novem oknu
Št. ogledov: 313
Št. prenosov: 103
Ocena: 0 (0 glasov)
Metapodatki: JSON JSON-RDF JSON-LD TURTLE N-TRIPLES XML RDFA MICRODATA DC-XML DC-RDF RDF

Ostali podatki

Sekundarni jezik: Slovenski jezik
Sekundarni naslov: Erect pelvic X-ray with and without fat tissue removal
Sekundarni povzetek: Introduction: The most commonly used projection for pelvic and hip radiography is the supine AP projection, but some studies advocate that it would be better to perform it in erect position as this would provide more diagnostically useful information. According to a previous study they reported reduced image quality and increased radiation dose for erect pelvic imaging in larger patients as they compared it to the supine pelvic X-ray. Purpose: The purpose of this study is to determine whether the radiation dose and image quality differ between two different erect pelvic radiographic procedures, with and without fat tissue removal. Methods: The measurements were divided into two parts. In the first part we determined which band did not produce artefacts on the resultant X-ray image when displacing fat tissue on the phantom. The second part was performed on 60 patients referred for erect pelvic imaging. They were randomly divided into two equal groups, half of them removed the fat tissue from the region of interest and the other group did not. We measured waist and hip circumference, height, weight, DAP, primary field size, source-to-skin distance, mAs and kV. BMI, ESD and effective dose were subsequently calculated. The images were evaluated by three radiologists. Results: In the phantom study we found that a thin cotton triangular bandage does not show any visible artefacts. The waist circumference before and after tissue removal was statistically different (p<0.001), as the thickness decreased by 4.7%, while hip circumference before and after removal was not statistically different (p=0.211). DAP was 38.5% lower in a group of patients with tissue removal (p=0.001). The ESD was 44% lower in a group in which patients moved the fat tissue from the region of interest (p<0.001). The effective dose was reduced by 38.7% in a group of patients with soft tissue removal (p<0.001). Hip joints (p=0.001), trochanters (p=0.021), acetabula (p<0.001), femoral necks (p=0.021), medulla and cortex of the pelvis (p=0.009), sacrum and its foramina (p=0.008) and the pelvic/hip soft tissues (p=0.039) were more visible on images obtained with fat tissue removal and were also statistically different. We found no significant differences between groups in visualisation of sacroiliac joints (p=0.055), the iliac crests (p=0.060) and the pubic/ischial rami (p=0.166). The total image score was higher in the patients with fat tissue removal (p=0.004). Discussion and conclusion: In this study we found that when taking a pelvic radiograph in the erect position, while moving fat tissue from the region of interest, the patient dose area product, the entrance skin dose and the effective dose decreases. This also affects the image quality, as it increases with the removal of the tissue and most of the anatomical structures of the pelvis are better visualised.
Sekundarne ključne besede: magistrska dela;radiološka tehnologija;slikanje medenice stoje;odmik mehkega tkiva;kakovost slike;dozna obremenitev;
Vrsta dela (COBISS): Magistrsko delo/naloga
Študijski program: 0
Komentar na gradivo: Univ. v Ljubljani, Zdravstvena fak., Oddelek za radiološko tehnologijo
Strani: 56 str., [6] str. pril.
ID: 13454794