Prikaz anatomskih struktur pri slikanju medenice : diplomsko delo

Gomzi, Katarina (author), Medič, Mojca (mentor), Starc, Tina (reviewer)

Uvod: Pri rentgenskem slikanju je pomembno, da je pacient postavljen v pravilen položaj ter, da je pravilno usmerjen centralni žarek. V primeru, da pacienta nismo postavili v pravilen položaj, se na rentgenogramu pojavi distorzija. Namen: Namen diplomske naloge je prikazati kako vplivamo na anatomski prikaz medenice z različnim podlaganjem medenice, rotacijami stegnenice ter nakloni centralnega žarka. Metode dela: Za raziskavo smo uporabili dva fantoma. Najprej smo posneli sliko v pravilnem položaju ter izmerili oddaljenost obeh velikih grč stegnenice od mize. Za vsako naslednjo sliko smo razdaljo na levi strani povečali za približno en centimeter. Fantom smo vrnili v pravilen položaj in spreminjali naklon centralnega žarka v kranialno in kavdalno smer. Naklon smo pri vsaki naslednji projekciji spreminjali za 5°. Največji naklon žarka je bil 45° kranialno in kavdalno. Nazadnje smo nastavili fantom z možnostjo rotacije stegnenic. Levo stegnenico smo nastavili v pravilen položaj in izmerili razdaljo med podlago in najnižjo točko zunanjega kondila stegnenice. Desno stegnenico smo nastavljali od maksimalne zunanje rotacije do maksimalne notranje rotacije, tako da smo zgoraj omenjeno razdaljo spreminjali za 0,5 cm, in sicer od štirih do desetih centimetrih. Rezultati: Pri spreminjanju položaja medenice smo dokazali, da se s povečevanjem podlaganja leve strani levo krilo črevnice projekcijsko oži, desno pa širi. Leva kolčnična lina se projekcijsko širi in je večja od desne, prav tako je večja kolčnica. Leva stegnenica se projekcijsko povečuje. Pri povečevanju naklona centralnega žarka kavdalno smo ugotovili, da se višini obeh kolčničnih lin manjšata, prav tako razdalji med malo in veliko grčo stegnenic. Velikost medeničnega vhoda pa z naraščanjem naklona centralnega žarka narašča. Pri povečevanju naklona centralnega žarka kranialno pa sta višina in razdalja med malo in veliko grčo naraščali. V zunanji rotaciji je vrat stegnenice skrajšan, mala grča v celoti vidna in projekcijsko zožana na medialnem robu, velika grča pa je projicirana v vrat stegnenice. Pri obračanju v notranjo rotacijo se vrat stegnenice malo skrajša, mala grča s projicira v njen vrat, velika grča pa je vidna na lateralnem robu in se malo projekcijsko skrajšana. Razprava in zaključek: Z raziskovalno nalogo smo dokazali, da je pomembna pravilna priprava pacienta, saj v primeru, da ni pravilno nastavljen ne dobimo simetrične slike in pravilnega položaja proksimalnega dela stegnenice. Če je pacient zvrnjen na eno stran, dobimo eno črevnico zožano, drugo pa v širše prikazano, proksimalni del stegnenice, ki je bolj oddaljena od podlage pa je projekcijsko povečan. S spreminjanjem centralnega žarka se nam nekatere strukture podaljšajo ali skrajšajo, nekatere pa prikažejo v pravilni obliki in velikosti, kot npr. križnica pri naklonu kranialno. Z večjimi koti prikažemo medenico v projekciji »intlet« in v projekciji »outlet«. Zelo pomembna je pravilna nastavitev nog. Z nepravilno rotacijo se nam mala in velika grča ne projicirata kot je zapisano v merilih ocenjevanja rentgenograma. Zato je pomembno, da pacientu razložimo, da se ne sme premikati ter mu noge fiksiramo.

• Language: Slovenian
• Keywords: diplomska dela, radiološka tehnologija, rentgensko slikanje, anatomski prikaz medenice, rotacije stegnenice
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [K. Gomzi]
• Year: 2020
• Number of pages: 29 str., [8] str. pril.
• PID: 20.500.12556/RUL-118679
• UDC: 616-07
• COBISS.SI-ID: 26623235
• Publication date in RUL: 30.08.2020

Secondary language

• Language: English
• Title: Presentation of anatomical structures in imaging of pelvis : diploma work

Abstract

Introduction: At x-ray scanning it is important that a patient is correctly positioned and that the central beam is correctly directed. The radiographic distortion appears if the patient is not correctly positioned. Purpose: The objective of the diploma thesis is to show how to influence the anatomic display of pelvis by different support of the pelvis, rotation of the femur and inclination of the central beam. Methods: Two phantoms were used for the research. First, we scanned in the correct position and measured the distance of both femur greater trochanters from the table. For every following image we increased the distance on the left side for approximately one centimetre. We set the phantom to the correct position and changed the incline of the central beam to cranial and caudal direction. The inclination was changed with every following projection by 5°. The biggest inclination of the beam was 45° cranial and caudal. At the end we set the phantom with the possibility of rotation of the femurs. We set the left femur to the correct position and measured the distance between the background and the lowest point of the outer condyle of the femur. We set the right femur from maximum outer rotation to maximum inner rotation so that we changed the mentioned distance for 0,5 centimetres, otherwise from four to ten centimetres. Results: At changing position of the pelvis we proved that by increased supporting of the left side the left wing of intestine projection narrows and the right side widens. The left hipbone line projection widens and is bigger than the right one and the ischium bone is bigger as well. The left femur gets bigger in projection. By increasing the inclination of the central beam caudally we established that the heights of both hipbone lines decrease, as well as the distances between the small and the greater trochanter of the femurs. By increasing the inclination of the central beam, the size of the pelvis entrance increases. By increasing the inclination of thee central beam cranially the height and the distance between the lesser and the greater trochanter increase. In the outer rotation the femoral neck is shorten, the lesser trochanter visually entirely seen and narrowed in projection at the medial edge, the greater trochanter projected into the femoral neck. In the inner rotation the femoral neck shortens a bit, the lesser trochanter is projected into the neck and the greater trochanter is visible at the lateral edge and is a little shortened in projection. Discussion and conclusion: With the research paper it was established that it is important to prepare the patient in the correct way. If the patient is not correctly positioned the image is not symmetrical and the position of the proximal part of the femur is not correct. If the patient lays on one side the intestine on that side is narrowed and on the other widened. The proximal part of the femur that is more distant from the surface is increased in projection. By changing the central beam some structures extend or shorten and some are shown in the correct form and size, like for example, sacrum at the cranial inclination. With larger angles the pelvis is shown in projection “inlet” and in projection “outlet”. It is very important how the legs are positioned. By incorrect rotation the small and the big gnarl do not project as it is written in the assessment criteria of radiograph. Therefore, it is relevant to explain the patient not to move and fix their legs.

• Keywords: diploma theses, radiologic technology, radiography, anatomical image of pelvis, rotation of femur