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Evaluation of quantitative on T-spine exhalation technique and T-spine breathing technique of natural breathing

T-spine exhalation technique과 자연스런 호흡 상태에서 촬영하는 T-spine breathing technique의 정량적 평가

  • Received : 2013.06.19
  • Accepted : 2013.09.06
  • Published : 2013.09.30

Abstract

Measurements of CNR(Contrast to Noise Ratio) and SNR(Signal to Noise Ratio) of T-spine breathing technique (TBT) using spontaneous breathing and T-spine exhalation technique (TET) with full exhalation were carried out, and with which the more appropriate method was suggested. Both TBT and TET were examined in a sample of fifty-three patients who visit to our hospital for spinal disease from June 2012 to November 2012. All images were evaluated with CNR measured from the differences between the mean pixels and contrast density as setting ROI of spinous process, pedicle, vertebral body, intervertebral foramen, and intervertebral disk using Image J. SNR was measured with the mean pixels and the standard deviation as setting ROI of vertebral body using Image J. In CNR comparison and SNR comparison of TET and TBT, TBT was indicated as excellent in ROI of pedicle, vertebral body, intervertebral foramen and intervertebral disk, and statistical analysis were significant(p<.01). As TBT indicated excellent images compared to the existing T-spine lateral radiography, T-spine lateral radiography would be reestablished and significant as applying to various medical institutions.

흉추 측면검사에서 기존의 T-spine exhalation technique (TET)과 환자의 자연스런 호흡 상태에서 촬영하는 T-spine breathing technique (TBT)의 대조도 잡음 비와 신호 대 잡음 비를 측정하여 적절한 검사기법을 제시하고자 하였다. 2012년 6월부터 2012년 11월까지 척추질환으로 본원을 내원하여 흉추 측면검사를 시행한 환자 53명을 대상으로 하였으며, 동일한 환자를 대상으로 측면 선 자세에서 기존의 TET와 TBT를 병행하였다. 화질 평가는 흉추 측면검사의 평가요소 중 5곳(극돌기, 추궁근, 추체, 추간공, 추간)을 Image J 프로그램을 이용하여 관심영역을 정하고 화소의 평균과 대조 농도와의 차이를 구하여 대조도 잡음 비를 측정하여 비교하였다. 또한 추체에 관심영역을 정하여 화소의 평균과 표준편차를 구하고 신호 대 잡음 비를 측정하여 비교하였다. TET와 TBT방법으로 촬영한 영상을 대조도 잡음 비와 신호 대 잡음 비에서 비교한 결과, TBT방법이 추궁근, 추체, 추간공, 추간의 구조에서 우수하게 나타났으며, 통계적으로 매우 유의하였다(p<.01). 기존의 심호기법에 비해 TBT방법으로 촬영한 영상은 우수한 화질을 제공하므로 이를 토대로 임상에 혼재되어 있는 흉추 측면 검사법을 재정립하고, 여러 의료기관에 적용할 경우, 유용성이 크다고 사료된다.

Keywords

References

  1. White A, Panjabi M, "Clinical biomechanics of the spine". J.B.Lippincott Company, pp.3-77, 1990.
  2. Andriacchi T, Schultz A, Belytschko T, Galante J, "A model for studies of mechanical interactions between the human spine and rib cage". J Biomech, pp.497-507, 1974. DOI: http://dx.doi.org/10.1016/0021-9290(74)90084-0
  3. Bohlman H, Freehafer A, Dejak J, "The results of treatment of acute injuries of the upper thoracic paralysis". J Bone Joint Surg, pp.360-369, 1985.
  4. Gertzbein SD, "Fractures of the thoracic and lumbar spine, Baltimore". Williams & Wikins, 1992.
  5. Shapiro S, Abel T, Rodgers RB, "Traumatic thoracic spinal fracture dislocation with minimal or no cord injury". Report of four cases and review of the literature, J neuro surg(Spine 3), pp.333-337, 2002.
  6. Singh K, Kim D, Vaccaro AR, "Thoracic and lumbar spinal injuries". The spine 5th ed, Philadelphia, Saunders, pp.1132-1156, 2006.
  7. B. J. Shin, T. K. Yun, H. S. Kang, J. C. Lee, K. J. Kim, Y. I. Kim, "Intraspinal gas with lumberjack injury". J of Korean Society of Spine Surg, 3, pp.195-201, 1996.
  8. S. S. Kang, S. G. Ko, I. H. Ko, "TEXTBOOK of Radiographic Positioning and Clinical Diagnosis". Chung-Ku publishing Co, pp.225-250, 2008.
  9. B. J. Shin, "Thoracic and lumbar spine injury, Department of Orthopaedic Surgery". Journal of Korean Spine Surg, 6(2), pp.271-280, 1999.
  10. K. S. Kim, S. Y. Son, K. S. Lee, D. Y. Ha, "A Study on usefulness of T-spine breathing-technique for improving image quality". pp.99-106, 2012.
  11. Doi K, "Diagnostic imaging over the last 50 years: research and development in medical imaging science and tecnology". Phys Med Biol, 51(13), pp.R5-R27, 2006. DOI: http://dx.doi.org/10.1088/0031-9155/51/13/R02
  12. J. M. Kim, J. W. Min, H. W. Jeong, E. K. Im, H. J. Yang, "The noise evaluation for Ragius 150 CR system". Journal of Korean Society of Radiological Technology, 29(4), pp.237-240, 2006.
  13. J. W. Min, J. M. Kim, H. W. Jeong, "Mixed noise reduction filters for CR Images". Journal of Korean Society of Radiological Technology, 30(1), pp.1-6, 2007.
  14. J. W. Min, J. M. Kim, H. W. Jeong, C. I. Ohk, "Research about filter association and clinical effect noise reduction of digital imaging system". Journal of Korean Society of Radiological Technology, 30(4), pp.329-334, 2007.
  15. H. W. Jeong, J. W. Min, J. M. Kim, M. S. Park, K. Y. Lee, "Performance characteristic of a CsI(TI) flat panel detector radiography system". Journal of Korean Society of Radiological Technology, 35(2), pp.109-117, 2012.
  16. H. S. Park, Y. N. Oh, H. J. Jo, S. T. Kim, Y. N. Choi, H. J. Kim, "Comparison study of image quality of direct and indirect conversion digital mammography system". Journal of Korean Society of Radiological Technology, 21(3), pp.239-245, 2010.
  17. H. K. Kim, M. K. Jo, "Investigation of radiation effects on the signal and noise characteristics in digital radiography". J. Biomed. Eng. Res, 28(6), pp.756-767, 2007.
  18. Fuller MJ, "Breathing Exposure Techniques in Radiography, Lateral chest x-ray Digital Double-Dipping, Soft Tissue Signs-Thoracic Spine". wikiRadiography.
  19. McEvoy RD, Bradford DS, "The management of burst fractures of the thoracic and lumbar spine, experience in 53 patients". Spine, 10, pp.631-637, 1985. DOI: http://dx.doi.org/10.1097/00007632-198509000-00007
  20. Daffner RH, Deeb ZL, Rothfus WE, "The posterior vertebral body line: importance in detection of burst fractures". Am J Roentgenol, 148, pp.93-96, 1987. DOI: http://dx.doi.org/10.2214/ajr.148.1.93
  21. Wang SC, Grattan-Smith A, "Thoracolumbar burst fractures: two "new" plain film signs with CT correlation". Australas Radiol, 31, pp.404-413, 1987. DOI: http://dx.doi.org/10.1111/j.1440-1673.1987.tb01862.x
  22. E. C. Jang, H. J. Jung, C. K. Park, "Diagnosis of Burst Fracture of the Spine on Plain Radiographs Using the Wintopo Program". J of Korean Orthop, ASSOC, 38, pp.432-436, 2003. https://doi.org/10.4055/jkoa.2003.38.4.432
  23. Andy C, "Modified Lateral Thoracic Spine Technique, Imaging Vertebral Body Wedge Fractures, Aluminium Filter Techniques in Radiography". wikiRadiography.