Primerjava doz in kakovost slik na fantomu pri izbranih projekcijah v diagnostični radiologiji : magistrsko delo

Majger, Martina (avtor), Mekiš, Nejc (mentor), Žibert, Janez (komentor), Škrk, Damijan (recenzent)

Uvod: Rentgensko slikanje glave, medenice in pljuč so ene izmed osnovnih diagnostičnih preiskav. Poleg tega pa slikanje medenice in pljuč spada med najbolj frekventne preiskave v splošni radiografiji. Namen: Namen magistrske naloge je primerjava doz in kakovosti rentgenskih slik pri slikanju glave, prsnih organov in medenice med slovenskimi zdravstvenimi ustanovami. Metode dela: Raziskava je vključevala 27 diagnostičnih rentgenskih aparatov in je bila izvedena na antropomorfnem fantomu. V raziskavo smo zajeli rentgenske protokole za slikanje prsnih organov, medenice in glave. Izmerili smo produkt doze in površine (DAP), izračunali vhodno kožno dozo (VKD) in efektivno dozo ter izmerili razmerje kontrast / šum (CNR). Skupni rezultat je bil izračunan za vsak rentgenski aparat na podlagi ocene za merila. Rezultati: Izračunane so bile vrednosti tretjega kvartila DAP in VKD za najpogostejše preiskave in primerjane z že ugotovljenimi diagnostičnimi referenčnimi ravnmi (DRL), ugotovljenimi med pregledom literature. Anodna napetost, ki jo uporablja vsak aparat, smo primerjali s priporočenimi vrednostmi. Pri slikanju glave v AP projekciji se v 30% (fantom 1) in 26% (fantom 2) slikanj vrednosti izbrane anodne napetosti nahajajo izven evropskih smernic ter 48% pri stranski projekciji. Pri slikanju medenice je v AP projekciji 22% meritev izven referenčnega intervala (75 kV - 90 kV). Pri slikanju prsnih organov v PA projekciji 30% meritev ustreza evropskim smernicam in ima referenčno vrednost pri 125 kV, pri stranski projekciji pa ustreza 33% meritev. Tretji kvartil vrednosti DAP za slikanje glave (fantom 1) v AP projekciji je 41,4 µGy.m2, v STR projekciji pa 26,9 µGym2. Pri slikanju glave (Fantom 2) v AP projekciji znaša tretji kvartil vrednosti DAP 44,5 µGym2 in pri STR 32,2 µGy.m2. Pri slikanju medenice v AP projekciji tretji kvartil predstavlja vrednost 99,5 µGym2. Pri slikanju prsnih organov v PA projekciji znaša tretji kvartil vrednosti DAP 4,5 µGy.m2 in pri STR 3,8 µGy.m2. Razprava in zaključek: Ugotovili smo, da obstajajo razlike pri ekspozicijskih pogojih, DAP vrednostih, efektivni dozi, dozi na posamezne organe in kakovosti rentgenskih slik med slovenskimi zdravstvenimi ustanovami. Vrednosti tretjega kvartila DAP in VKD pri vseh diagnostičnih rentgenskih aparatih je večinoma dokaj nizka v primerjavi z drugimi raziskavami, ampak vseeno so za izboljšanje kakovosti slike ali zmanjšanje doze sevanja priporočljive nekatere spremembe v slikovnih protokolih na splošnih rentgenskih aparatih.

• Jezik: Slovenski jezik
• Ključne besede: magistrska dela, radiološka tehnologija, ekspozicijski pogoji, DAP, vstopna kožna doza, efektivna doza, kakovost rentgenskih slik
• Vrsta gradiva: Magistrsko delo/naloga
• Tipologija: 2.09 - Magistrsko delo
• Organizacija: ZF - Zdravstvena fakulteta
• Kraj izida: Ljubljana
• Založnik: [M. Majger]
• Leto izida: 2021
• Št. strani: 86 str., [16] str. pril
• PID: 20.500.12556/RUL-126875
• UDK: 616-07
• COBISS.SI-ID: 62243075
• Datum objave v RUL: 07.05.2021

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Comparison of radiation dose and quality of phantom images in selected imaging protocols in diagnostic radiology : master thesis

Izvleček

Introduction: X¬-rays of the head, pelvis and lungs are one of the basic diagnostic tests. However, pelvic and lung x-rays imaging is one of the most frequent examinations in general radiographs. Purpose: The purpose of the research was to compare radiation dose and image quality for pelvis, chest and head imaging between all major Slovenian healthcare institutions. Methods: The study included 27 X-ray units and was performed on anthropomorphic phantoms. In the study we included X-ray protocols for images of the chest, pelvis and head. Dose area product (DAP) was measured, entrance skin dose (ESD) and effective dose were calculated, contrast-to-noise ratio (CNR) was measured. Total score was calculated for each unit based on the evaluation of each criterion.Results: 3rd quartile DAP and ESD values for most common examinations were calculated and compared to already established diagnostic reference levels (DRLs) found during literature review. Tube voltages used by each unit were compared to recommended values. When imaging the head in the AP projection, in 30% (phantom 1) and 26% (phantom 2) of the images, the values of the selected anode voltage are outside the European guidelines and 48% in the side projection. In pelvic imaging, in the AP projection, 22% of measurements are otside of the refrence interval (75 kV - 90 kV). When imaging the thoracic organs in the PA projection, 30% of the measurements correspond to European guidelines and have a refrence line at 125 kV, while in the side projection it corresponds to 33% of the measurements. The third quartile of DAP values for head imaging (Phantom 1) in AP projection is 41.4 μGym² and 26.9 μGy.m² in STR projection. For head imaging (Phantom 2) in AP projection, the third quartile of DAP values are 44.5 μGy.m² and 32.2 μGy.m² in STR. In pelvic imaging in AP projection, the third quartile represents a value of 99.5 μGy.m². For lung imaging in PA projection, the third quartile of DAP value is 4.5 μGy.m² and 3.8 μGy.m² in STR. Discussion and conclusion: We found that there are differences with exposure parameters, DAP values, effective dose, dose on a specific organ and image quality among Slovenian medical institutions. The DAP and VKD values of the third quartile in a diagnostic X-ray machines are generally quite low compared to other studies, but some changes in imaging protocols on diagnostic X-ray machines are still recommended to improve image quality or reduce radiation dose.

• Ključne besede: master's theses, radiologic technology, exposure conditions, DAP, entry skin dose, effective dose, x-ray image quality