Določanje tipičnih bolnišničnih vrednosti doz za najbolj pogoste preiskave v splošni radiografiji : magistrsko delo

Mekiš, Nejc (mentor), Karič, Maja (comentor), Kukuljan, Melita (comentor), Škrk, Damijan (reviewer), Pergar, Lucija (author)

Uvod: Glavni koncept varstva pred sevanji je zaščititi bolnika pred nepotrebnim sevanjem in opraviti pregled z najmanjšim možnim odmerkom. Pri optimizaciji sevanja nam pomagajo diagnostične referenčne ravni (DRL). To so vrednosti doz ionizirajočega sevanja, za katere pričakujemo, da pri optimiziranih posegih niso presežene. Pri določitvi diagnostičnih referenčnih ravni upoštevamo vrednosti tretjega kvartila porazdelitve vzorca povprečnih vrednosti doz. Namen: Določitev tipičnih bolnišničnih vrednosti doz za najpogosteje preiskave v splošni radiografiji. Namen raziskave je tudi primerjava dveh rentgenskih aparatov na dveh različnih enotah; Reka in Sušak, ter ugotavljanje razlik med njima pri izvajaju najpogostejših radioloških preiskav. Metode dela: Raziskava je potekala v dveh različnih bolnišnicah. Izbrali smo podatke o najpogostejših radioloških posegih za obdobje enega meseca. Za vsakega pacienta smo beležili višino in maso ter izračunali indeks telesne mase (ITM). Hkrati smo beležili ekspozicijske pogoje, velikost polja ter DAP (dozo). S pomočjo programa PCXMC smo izračunali efektivno dozo. Na koncu smo v programu SPSS primerjali zbrane podatke. Rezultati in razprava: Z raziskavo smo določili, da tipična bolnišnična vrednost za kolk v AP projekciji znaša 35,50 μGym2 , za medenico v AP projekciji pa 77,40 μGym2 . Za pljuča v PA projekciji je tipična vrednost doze 5,30 μGym2 , v STR projekciji pa 16,50 μGym2 . Pri AP projekciji rame je ta vrednost 10,25 μGym2 , medtem ko je za rebra v AP projekciji 84,65 μGym2 , za polstransko projekcijo pa 84,90 μGym2 . Tipična vrednost doze za vratno hrbtenico v AP projekciji znaša 7,30 μGym2 , v STR projekciji pa 5,15 μGym2 . Pri slikanju AP projekcije prsne hrbtenice je tipična vrednost določena kot 35,10 μGym2 , pri STR projekciji je ta vrednost 37,35 μGym2 . Za AP projekcijo ledvene hrbtenice je določena tipična vrednost 81,90 μGym2 , za STR projekcijo pa 92,20 μGym2 . Zaključek: Ker je samo pri AP projekciji vratne hrbtenice ter pri AP projekciji ledvene hrbtenice določena višja dignostična referenčna vrednost kot vrednost tretjega kvartila v naši študiji ter največja razlika znaša 4,37 % v primerjavi z drugimi študijami, ugotavljamo dobro radiološko prakso.

• Language: Slovenian
• Keywords: magistrska dela, radiološka tehnologija, tipične bolnišnične vrednosti doz, diagnostične referenčne ravni, splošna radiografija, DAP, efektivna doza
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [L. Pergar]
• Year: 2021
• Number of pages: 59 str., [2] str. pril.
• PID: 20.500.12556/RUL-125629
• UDC: 616-07
• COBISS.SI-ID: 58148867
• Publication date in RUL: 28.03.2021

Secondary language

• Language: English
• Title: Establishment of typical dose values for most common procedures in general radiography : master thesis

Abstract

Introduction: The main concept of radiation protection is to protect the patient from unnecessary radiation and to perform the examination with the lowest possible dose. Diagnostic reference levels (DRLs) help us optimize radiation. These are the values of ionizing radiation doses that are not expected to be exceeded in optimized procedures. In determining the diagnostic reference levels, the values of the third quartile of the sample distribution of the mean dose values are taken into account. Purpose: Determination of typical hospital dose values for the most common examinations in general radiography. The purpose of the research is also to compare two X-ray machines on two different units; Reka and Sušak and identifying any differences between them in performing the most common radiological examinations. Methods: The study was conducted in two different hospitals. At each site, we collected data on the most common radiological procedures in general radiography for one month. Height and weight were recorded for each patient and body mass index (BMI) was calculated later. At the same time, exposure conditions, field size and DAP (dose) were recorded. The effective dose was calculated using the PCXMC program. In the end, we compared the collected data in the SPSS program with the help of various statistical tests. Results and discussion: The study determined that the typical hospital value for the hip in the AP projection is 35,50 μGym2 , and for the pelvis in the AP projection 77,40 μGym2 . The typical value for the lungs in the PA projection is 5,30 μGym2 , and in the STR projection 16,50 μGym2 . In the AP projection of the shoulder, this value is 10,25 μGym2 , while for the ribs in the AP projection it is 84,65 μGym2 , and for the half-sided projection it is 84,90 μGym2 . The typical value for the cervical spine in the AP projection is 7,30 μGym2 , and in the STR projection 5,15 μGym2 . In imaging the AP projection of the thoracic spine, the typical value is set to 35,10 μGym2 , in the STR projection this value is 37,35 μGym2 . A typical value of 81,90 μGym2 was determined for the AP projection of the lumbar spine and 92,20 μGym2 for the STR projection. Conclusion: As only the AP projection of the cervical spine and the AP projection of the lumbar spine set a higher diagnostic reference value than the value of the third quartile in our study and the largest difference is 4,37 % compared to other studies, we find good radiological practice.

• Keywords: master's theses, radiologic technology, typical dose values, diagnostic reference levels, general radiography, DAP, effective dose