Primerjava med slikanjem prsnih organov v anteroposteriorni in posteroanteriorni projekciji : diplomsko delo

Sluga, Janja (author), Starc, Tina (mentor), Mekiš, Nejc (comentor)

Uvod: Rentgensko slikanje prsnih organov je najpogostejša diagnostična radiološka preiskava. Namen: Namen diplomske naloge je bil primerjati rentgensko slikanje pljuč v anteroposteriorni (AP) in posteroanteriorni (PA) projekciji, z namenom ugotoviti, ali so navedene razlike med projekcijama v literaturi prikazane in vidne tudi na rentgenogramih prsnih organov v navedenima projekcijama ter ugotoviti, ali zaznamo razliko v DAPu, efektivni dozi in absorbirani dozi na izbrane radiosenzitivne organe v AP in PA projekciji. Metode dela: Raziskavo smo izvedli v dveh delih. V prvem delu smo primerjali rentgenograme prsnih organov pacientov, ki smo jih pridobili iz elektronsko prosto dostopne baze in lastno pridobljene slike. Primerjali smo rentgenograma pljuč istega pacienta v AP in PA projekciji po merilih za ocenjevanje rentgenograma V drugem delu smo izvedli meritve DAP in izračunali efektivne doze ter absorbirane doze na izbrane radiosenzitivne organe v področju prsnih organov fantoma. Naredili smo 20 rentgenogramov, 10 leže na razdalji gorišče-slikovni sprejemnik (RGS) 115 cm, 5 v AP in 5 v PA projekciji, ter 10 stoje na razdalji gorišče slikovni sprejemnik 180 cm, prav tako 5 v AP in 5 v PA projekciji. Rezultati: Rezultati primerjav rentgenogramov pljuč v AP in PA projekciji so pokazali razlike v prikazu struktur. V PA projekciji je srce bližje realni velikosti, lopatici sta projicirani bolj lateralno, izven pljuč, ključnici nista projicirani previsoko v apekse pljuč. V AP projekciji je srce povečano in podaljšano, lopatici sta projicirani bolj medialno, ključnici sta projicirani višje ter bolj vodoravno, prsni koš je videti širši in plitvejši. Artefakti ter zasuk pacienta v eno stran, so pogostejši v AP projekciji kot v PA projekciji, zaradi stanja pacienta, ki mnogokrat onemogoča odstranitev različnih medicinskih pripomočkov. Rezultati meritev na fantomu so pokazali, da je DAP nižji v PA projekciji kot v AP projekciji, na RGS 115 cm za 7,6 %, na RGS 180 cm pa za 4,8 %. Efektivna doza je nižja v PA projekciji kot v AP projekciji za 82,9 % na RGS 115 cm ter za 39, 9 % na RGS 180 cm. Absorbirana doza na radiosenzitivne organe kot so dojke, žolčnik, srce, jetra, trebušna slinavka, želodec, priželjc in ščitnica, je nižja v PA projekciji kot v AP projekciji. Doza, ki jo prejmejo pljuča, požiralnik in vranica je nižja v AP projekciji kot v PA projekciji. Razprava in zaključek: PA projekcija je metoda izbora za rentgensko slikanje pljuč, saj sta kakovost rentgenograma ter dozna obremenitev optimalnejša v PA projekciji.

• Language: Slovenian
• Keywords: pljuča, rentgensko slikanje pljuč, AP in PA projekcija, radiosenzitivni organi
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2019
• PID: 20.500.12556/RUL-106273
• COBISS.SI-ID: 5584491
• Publication date in RUL: 19.02.2019

Secondary language

• Language: English
• Title: Comparison between chest imaging in anteroposterior and posteroanterior projection : diploma work

Abstract

Introduction: X-ray of the thoracic organs is the most common diagnostic radiological test. Purpose: The purpose of the BA thesis was to compare lung X - ray in anterior-posterior (AP) and posterior-anterior (PA) projection, in order to determine whether the literature-based differences between the projections are also detected and visible in radiographs of the thoracic organs in the above- mentioned projections. In addition, the aim was to ascertain whether a difference in DAP, the effective dose and absorbed dose on selected radiosensitive organs in AP and PA projections is observed. Methods of work: The study was carried out in two parts. In the first part, we compared the patients’ chest radiographs, obtained from a freely accessible electronic base of medical records, to own acquired images. We compared lung radiographs of the same patient in AP and PA projections according to the standards for the evaluation of radiographs. In the second part, we performed DAP measurements, and calculated effective doses and absorbed doses on selected radiosensitive organs in the area of the thoracic organs of the phantom. We did 20 X-ray images, 10 of it in horizontal position at the distance of 115cm between the source spot on the tube and the image receptor (SID) - 5 in AP and 5 in PA projection - and 10 images in the upright position at SID 180cm, also 5 in AP and 5 in PA projection. Results: The results of the comparison of lung radiographs in AP and PA projections demonstrated differences in structure view. The heart is closer to its real size in the PA projection; shoulder blades are projected more laterally and outside the lungs, the collarbones are not projected too high in the apex of lungs. In the AP projection, the heart is bigger and extended, shoulder blades are projected more medially, collarbones are projected higher and more horizontally, the chest looks wider and shallower. Artefacts and displacement of the patient to the side are more frequent in AP projection rather than in the PA due to the patient's condition, which often disables the removal of various medical devices. The results of the phantom measurements showed lower DAP values in PA projection compared to those in AP projection (values at SID 115 cm lower by 7.6 %, at SID 180 cm by 4.8 %). The effective dose is lower in PA projection by 82.9 % at SID 115 cm and by 39, 9% at SID 180 cm. The absorbed dose for radiosensitive organs such as breasts, gall bladder, heart, liver, pancreas, stomach, thymus and thyroid is lower in PA projection. The dose received by the lungs, the oesophagus and the spleen is lower in AP projection. Discussion and conclusion: The PA projection is the preferred method of choice for lung X-ray imaging, since the quality of the radiograph and a dose of radiation are more optimal than in the AP projection.

• Keywords: lungs, lung x-ray, AP and PA projection, radiosensitive organs