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Rentgensko slikanje medenice: z uporabo drugačne postavitve pacienta do zmanjšanja doze : magistrsko delo
ID Resnik, Anja (Author), ID Žibert, Janez (Mentor) More about this mentor... This link opens in a new window, ID Mekiš, Nejc (Comentor)

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Abstract
Uvod: Rentgensko slikanje medenice postavljamo v sam vrh najpogosteje sevalno obremenjujočih preiskav. Glede na majhno število predhodnih raziskav, bi se morali osredotočiti na zmanjšanje doz v povezavi z namestitvijo pacienta glede na položaj ionizacijskih celic AEC sistema digitalne radiografije. Namen: Namen je ugotoviti, kako se spreminja DAP, efektivna doza, absorbirana doza na organe in vpliv na kakovost slike glede na kranialno ali kavdalno namestitev pacienta pri rentgenskem slikanju medenice. Metode dela: Raziskavo smo izvedli v dveh delih na dveh digitalnih rentgenskih aparatih. V prvem delu smo merili doze na fantomu, kjer smo 10 slik posneli v HT in 10 slik v HA postavitvi. Drugi del raziskave pa smo izvedli na 200 pacientih (po sto na vsakem aparatu), ki so bili napoteni na rentgensko slikanje medenice. Merili smo DAP, velikost polja, višino in maso iz katerega smo izračunali ITM. Na podlagi predhodnih raziskav smo izračunali tudi efektivno dozo in absorbirano dozo na izbrane organe. Rentgenograme so neodvisno ocenili trije specialisti radiologi. Rezultati: Raziskava na fantomu in pacientih pri obeh rentgenskih aparatih ni pokazala statistično značilnih razlik v velikosti polja in ITM-u. DAP na Siemens Ysio pokaže 9,5% (p=0,032) razliko na fantomu in 37,3 % (p=0,002) razliko pri pacientih v prid kavdalne nastavitve. Efektivna doza je na Siemens Ysio v kavdalnem položaju nižja za 35,7% in je statistično značilno različna (p=0,002). Pri primerjanju absorbiranih doz na izbrane organe smo statistično značilno razliko izmerili pri slikanju pacientov na Siemens Ysio in sicer pri: mehurju (36,5 %), koži (35 %), spodnjemu debelemu črevesju (35 %), skeletu medenice (33 %), maternici (32,8 %), jajčnikih (32,4 %) in debelem črevesju (28,8 %). Ocene radiologov so bile za 5,4 % višje v kavdalni nastavitvi pri Siemens Ysio, drugače pa statistično značilnih razlik na fantomu ali pacientih nismo odkrili. Pri Siemens Luminus ne najdemo statistično značilnih razlik. Razprava: Zaradi položaja ionizacijskih celic se rezultati med Siemens Luminus in Ysio razlikujeta. Statistično značilne razlike v DAP-u, efektivni dozi, absorbirani dozi na izbrane organe pri zamenjavi položaja pacienta najdemo pri Siemens Ysio. Zaključek: Ob ohranitvi kakovosti slike smo pri kavdalni namestitvi na Siemens Ysio znižali DAP za 37,7 %, povprečno efektivno dozo za 35,7 % in povprečno absorbirano dozo na izbrane organe za 33,4 %. Zaključimo, da je slikanje v kavdalni namestitvi glede na ionizacijske celice priporočljiva metoda.

Language:Slovenian
Keywords:medenica, zmanjšanje doze, AEC, kavdalna nastavitev, kakovost slike
Work type:Master's thesis/paper
Organization:ZF - Faculty of Health Sciences
Year:2018
PID:20.500.12556/RUL-103851 This link opens in a new window
COBISS.SI-ID:5493099 This link opens in a new window
Publication date in RUL:27.09.2018
Views:3511
Downloads:536
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Secondary language

Language:English
Title:Pelvis imaging: achieving dose reduction with different patient position : master thesis
Abstract:
Introduction: X-ray imaging of the pelvis is placed at the very top of the most frequent radiation-burdening investigations. According to a minority of previous studies, a reduction in doses should be concentrated in conjunction with the patient's positioning according to the position of the ionizing cells of the AEC digital radiography system. Purpose: The purpose is to determine how DAP, effective dose, doses to specific organs and image quality are changing according to cranially or caudally orientated position in the X-ray of the pelvis. Methods: The research was carried out in two parts. In the first part of the study we measured doses on the phantom, where 10 images were taken in HT and 10 in the HA layout. The second part of the study was expanded to 200 patiens, one hundred per each x-ray mashine. We measured DAP, field size, height and mass from which we calculated ITM. Then we calculated effective dose and absorbed dose for individual organs accordingly. The radiographs were independently evaluated by three radiologists. Results: The research on the phantom and patients on both x-ray machines did not show statistically significant differences in field size and ITM. DAP on Siemens Ysio shows a 9,5 % (p = 0.032) difference on the phantom and 37,3 % (p = 0.002) the difference in patients in favor of a cavalous setting. The Efective dose on Siemens Ysio is lower by 35,7 % in the HA position and is statistically significantly different (p = 0.002). In the measurement of effective doses on individual organs, the statistically significant difference was measured in patients imaging on Siemens Ysio: bladder (36.5 %), skin (35 %), lower colon (35 %), pelvis pelvis (33 %), the uterus (32,8 %), the ovaries (32,4 %) and the large intestine (28,8 %). We did not find significant differences at Siemens Luminus. Radiologists estimates were 5, 4% higher in caudally orientated position at Siemens Ysio, but otherwise statistically significant differences were not detected on the phantom or patients. Discussion: Due to the position of ionization cells, the results between Siemens Luminus and Ysio differ. Statistically significant differences in DAP, effective dose, absorbed dose to selected organs in the replacement of the patient's position can be found at Siemens Ysio.Conclusion: While preserving the image quality, using the caudally orientated position at Siemens Ysio reduced the DAP by 37,7 % and the average effective dose by 35,7 %. The mean absorbed dose to selective organs is 33,4 %. We conclude that positioning patiens caudally orientated according to ionizing cells is a method of selection.

Keywords:pelvis, dose-optimisation, AEC, caudally orientated, image quality

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