Primerjava kakovosti slike in dozne obremenitve pacienta pri slikanju medenice v stoječem postero-anteriornem in antero-posteriornem položaju

Hajdarević, Amir (avtor), Mekiš, Nejc (mentor), Dolenc, Laura (komentor), Matjašič, Alenka (komentor)

Uvod: Radiografija medenice je znana po visoki stopnji sevanja. Za zmanjšanje sevalne obremenitve pacienta nekateri avtorji menijo, da je bolje uporabiti posteroanteriorno kot anteroposteriorno projekcijo. Namen: Namen je ugotoviti, če in za koliko se doza ionizirajočega sevanja, ki jo prejme pacient, spremeni ter vpliv na kakovost slike pri rentgenskem slikanju medenice pri uporabi posteroanteriorne projekcije namesto anteroposteriorne projekcije. Metode dela: Raziskavo smo razdelili na dva dela. V prvem delu smo uporabili fantom, pri čemer smo izvedli 5 slik v anteroposteriorni in 5 slik v posteroanteriorni projekciji. Drugi del raziskave smo izvedli v kliničnem okolju in je zajemal 100 pacientov, 50 v anteroposteriorni in 50 v posteroanteriorni projekciji. Zabeležili smo njihovo maso in višino, velikost polja, debelino slikanega predela, produkt doze in površine ter izračunali efektivno dozo. Vse rentgenske posnetke so na koncu neodvisno ocenili trije specialisti radiologi. Rezultati: Raziskava na fantomu je pokazala, da je bilo polje pri posteroanteriorni projekciji večje za 83,52 cm2, kar pa ni statistično značilno (p = 1,000). Pri anteroposteriorni projekciji je bil produkt doze in površine manjši za 16,73 µGy*m2, kar je statistično značilno različno (p = 0,008). Meritve efektivne doze so pokazale, da je bila doza pri posteroanteriorni projekciji manjša za 41,35 µSv, je statistično značilna razlika (p = 0,008). Pri pacientih je bilo polje večje pri posteroanteriorni projekciji za 131,47 cm2 in obstaja statistično značilna razlika (p < 0,001). Debelina trebuha se je pri posteroanteriorni projekciji statistično značilno zmanjšala za 2,66 cm (p < 0,001). Produkt doze in površine se je zmanjšal v posteroanteriorni projekciji za 8,55 µGy m2, ni statistično značilne razlike (p = 0,393). Efektivna doza se je v posteroanteriorni projekciji statistično značilno zmanjšala za 165,99 µSv (p < 0,001). Ocena rentgenogramov je bila v povprečju za 1,91 % večja pri posteroanteriorni projekciji, med ocenami ni statistično značilnih razlik (p = 0,066). Razprava in zaključek: Rezultati kažejo, da je uporaba posteroanteriorne projekcije pri slikanju medenice zmanjšala produkt doze in površine za 3,54 % in efektivno dozo za 51,49 %, pri čemer se je ohranila kakovost slike. Glede na to lahko sklepamo, da je slikanje medenice v posteroanteriorni projekciji boljša izbira.

• Jezik: Slovenski jezik
• Ključne besede: medenica, posteroanteriorna projekcija, zmanjšanje doze, kakovost slike
• Vrsta gradiva: Magistrsko delo/naloga
• Organizacija: ZF - Zdravstvena fakulteta
• Leto izida: 2024
• PID: 20.500.12556/RUL-159832
• Datum objave v RUL: 27.07.2024

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Comparison of image quality and radiation dose in erect pelvic radiography in postero-anterior and antero-posterior projection

Izvleček

Introduction: Pelvic radiography is known for its high radiation dose. To reduce the patient's radiation exposure, some authors suggest that it is better to use the posteroanterior projection rather than the anteroposterior projection. Purpose: The purpose is to determine if and by how much the dose of ionizing radiation received by the patient changes, as well as the impact on image quality in pelvic X-ray imaging when using the posteroanterior projection instead of the anteroposterior projection. Methods: The study was divided into two parts. In the first part, we used a phantom and performed 5 images in the anteroposterior projection and 5 images in the posteroanterior projection. The second part was conducted in a clinical setting and involved 100 patients, 50 in the anteroposterior projection and 50 in the posteroanterior projection. We recorded their weight and height, field size, thickness, dose-area product, and calculated the effective dose. All X-ray images were independently evaluated by three specialist radiologists. Results: The phantom study showed that the field size in the posteroanterior projection was larger by 83.52 cm², which was not statistically significant (p=1.000). In the anteroposterior projection, the dose-area product was smaller by 16.73 µGy*m², a statistically significant difference (p=0.008). Effective dose indicated that it was 41.35 µSv lower in the posteroanterior projection, a statistically significant difference (p=0.008). In patients, the field size was larger in the posteroanterior projection by 131.47 cm², and was statistically significant (p<0.001). The abdominal thickness was significantly reduced by 2.66 cm in the posteroanterior projection (p < 0.001). The dose-area product was reduced in the posteroanterior projection by 8.55 μGy*m², this was not statistically significant (p=0.393). The effective dose was significantly reduced by 165.99 µSv in the posteroanterior projection (p<0.001). The average radiograph assessment score was 1.91% higher in the posteroanterior projection, with no statistically significant difference between the scores (p=0.066).Discussion and conclusion: The results indicate that using the posteroanterior projection in pelvic imaging reduced the dose-area product by 3.54% and the effective dose by 51.49%, while maintaining image quality. Based on this, we can conclude that pelvic imaging in the posteroanterior projection is a better choice.

• Ključne besede: pelvis, use of posteroanterior projection, dose reduction, image quality