Primerjava anteroposteriorne in posteroanteriorne projekcije slikanja ledvene hrbtenice : magistrska naloga

Alukić, Erna (avtor), Škrk, Damijan (mentor), Mekiš, Nejc (komentor)

Uvod: Slikanje ledvene hrbtenice je klasificirano kot preiskava z največjo dozno obremenitvijo v klasični radiografiji. Obstaja preprost, vendar učinkovit način za zmanjšanje doze sevanja in sicer zamenjava anteroposteriorne (AP) projekcije slikanja v posteroanteriorno (PA) projekcijo. Namen: Namen je ugotoviti, kako se pri uporabi PA projekcije spremeni doza ionizirajočega sevanja pri rentgenskem slikanju ledvenih vretenc ter ali PA projekcija vpliva in spremeni kakovost slike v primerjavi z AP projekcijo. Metode dela: Raziskavo smo izvedli v dveh delih. V prvem delu raziskave smo merili dozo (DAP) na fantomu, kjer smo naredili 5 slik v AP in 5 v PA projekciji. Drugi del raziskave smo izvedli na 100 pacientih, ki smo jih naključno razdelili v dve skupini po 50, nato pa slikali prvo skupino v AP in drugo v PA projekciji. Pri vseh pacientih smo beležili maso in višino za izračun indeksa telesne mase (ITM), hkrati pa smo primerjali tudi velikost polja, debelino trebuha, DAP in efektivno dozo. Vse rentgenograme so na koncu neodvisno ocenili trije specialisti radiologi. Rezultati in razprava: Raziskava na fantomu je pokazala, da je bilo polje pri PA projekciji večje za 62,6 cm2, ki pa ni statistično značilno (p = 0,310), pri AP projekciji je bil DAP manjši za 1,9 µGy m2 in tudi ni statistično značilno različen (p = 0,310), ocena rentgenogramov pa je bila boljša pri AP projekciji za 0,2, vendar tudi statistično neznačilna (p = 0,690). Meritev efektivne doze je bila pri PA projekciji manjša za 0,033 mSv, kjer smo ugotovili statistično značilne razlike (p = 0,008). Pri pacientih je bilo polje večje pri PA projekciji za 8 cm2, vendar ne statistično značilno (p = 0,391). Debelina trebuha se je pri PA projekciji statistično značilno zmanjšala za 2,4 cm (p < 10-3), prav tako tudi DAP za 16,3 µGy m2 (p = 0,009) in efektivna doza za 0,09 mSv (p < 10-3), razlike so bile statistično značilne. Ocena rentgenogramov je bila za 0,1 večja pri PA projekciji, vendar med ocenami ni bilo statistično značilnih razlik (p = 0,690). Zaključek: Rezultati so pokazali, da je uporaba PA projekcije pri slikanju ledvene hrbtenice zmanjšala DAP (26,7 %) in efektivno dozo (53,3 %) ob ohranitvi kakovosti slike, torej lahko zaključimo, da je slikanje ledvenih vretenc v PA projekciji priporočljiva metoda izbora.

• Jezik: Slovenski jezik
• Ključne besede: ledvena hrbtenica, uporaba PA projekcije, zmanjšanje doze, kakovost slike
• Vrsta gradiva: Magistrsko delo/naloga
• Organizacija: ZF - Zdravstvena fakulteta
• Leto izida: 2017
• PID: 20.500.12556/RUL-94582
• COBISS.SI-ID: 5303147
• Datum objave v RUL: 05.09.2017

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Comparison of anteroposterior and posteroanterior projection in lumbar spine radiography : master thesis

Izvleček

Introduction: Radiography of lumbar spine is classified as a relatively high dose examination in classical radiography. There is a simple but effective way to reduce the radiation dose, namely the replacement of the anteroposterior (AP) imaging projection into the posteroanterior (PA) projection. Purpose: The purpose is to determine how dose of radiation in X-ray examination of lumbar spine is changed when using the PA projection and does the PA projection have influence and change the image quality compared to the AP projection. Methods: The research was carried out in two parts. In the first part of the study we measured the dose (DAP) on the phantom, where we made 5 images in the AP and 5 images in the PA projection. The second part of the study was carried out on the 100 patients, randomly divided into two groups of 50. We took images of one group in the AP and the other in the PA projection. For all patients, we recorded the mass and height for the body mass index (BMI), and at the same time we compared the size of the field, the thickness of the abdomen, DAP and the effective dose. On the end, all radiographs were evaluated independently by three radiologists. Results and discussion: A study on the phantom showed that the field at the PA projection was 62,6 cm2 larger compared to average values of the AP projection (p = 0,310). The AP projection was even better with DAP by 1,9 μGy m2 (p = 0,310) and at the evaluation of radiographs by 0,2 (p = 0,690). The measurement of the effective dose was lower by 0,033 mSv for PA projection, where statistically significant differences were found (p = 0,008). Measurements on the patients showed that the field was larger with a PA projection by 8 cm2 (p = 0,391). The thickness of abdomen was reduced by 2,4 cm (p <10-3) in the PA projection, as did DAP by 16,3 μGy m2 (p = 0,009) and the effective dose by 0,09 mSv (p <10-3), which means that the differences were statistically significant. The estimation of radiographers was 0,1 higher for PA projection, but there were no statistically significant differences between the estimates (p = 0,690). Conclusion: The results showed that the use of PA projection of lumbar spine reduces DAP (26,7 %) and effective dose (53,3 %) while preserving the image quality, so we can conclude that the imaging of lumbar spine in PA projection is recommended method of selection.

• Ključne besede: lumbar spine, use of PA projections, dose reduction, image quality