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Quality Assessment for Elbow CT scan by positioning and respiratory control

팔꿈치관절 CT검사에서 환자 자세 및 호흡에 따른 화질평가

  • 임종천 (한양대학교병원 영상의학과) ;
  • 박상현 (한양대학교병원 영상의학과) ;
  • 이인재 (한양대학교병원 영상의학과)
  • Received : 2017.02.01
  • Accepted : 2017.06.13
  • Published : 2017.07.25

Abstract

Because the arm can't be sutured due to fracture during a elbow CT scan, a CT scan is proceeded in a state of abdomen and L-spire are overlapped which beam hardening artifact is done many times, and it often lowers the quality of elbow CT images. So there are many difficulties in reading and due to increase in radiation dose from it, the number of patient's exposure keeps increasing. In this research, it plans to improve the quality of the images by avoiding overlap with abdomen, and increasing the number of photon overlapped with lung field which the line attenuation is relatively small. The way of experiment is based on patient's right elbow and place him as head first position, then place his elbow at L2-3 level in supine position, turn about 30 degrees to the left in non-control breathing and in supine position, and compared with full inspiration after overlapping with lung. After figuring out the average value and standard deviation data using Image J program 5 times each for 16, 128 channels, the evaluation is proceeded by measuring each of CNR, MSR are statistically analyzed using SPSS program. Therefore, through positioning and inspiration during elbow CT scan, the way of inspection minimized the exposure radiation dose, and seems to be meaningful in a way to improve the quality of the images.

팔꿈치관절 CT 검사 시에 골절 등으로 인해 부득이하게 팔을 거상하지 못할 때에 주로 선 감약이 많이 되는 복부 장기 및 요추에 중복된 상태로 검사하여 영상의 질이 저하되는 경우가 많다. 그로 인해, 판독에 많은 어려움이 있으며 선량 증가로 인해 환자의 피폭이 많아지고 있다. 본 실험에서는 복부 장기와의 중복을 피하고 상대적으로 선 감약이 적은 폐야와 중복되어 광자량을 증가시켜 영상의 질 향상을 도모하고자 하였다. 실험 방법은 환자의 오른쪽 팔꿈치관절을 대상으로 하여 환자를 바로 누운 자세에서 팔꿈치관절을 L2-3 level에 위치시킨 방법과 바로 누운 자세에서 왼쪽으로 30도 정도 돌려서 폐야와 중첩하고 완전한 흡기 상태에서 비교하여 진행하였다. 16, 128채널 각각 5회씩 측정하여 나온 데이터를 Image J 프로그램을 이용하여 평균값 및 표준편차를 구한 뒤 신호 대 잡음 비(SNR), 대조도 대 잡음 비(CNR), 평균대 표준편차 비(MSR)를 각각 측정하여 평가를 시행하였다. SPSS 프로그램을 이용하여 CNR, MSR을 통계 분석하였고 각각의 인자가 향상된 결과를 얻을 수 있었다. 따라서 팔꿈치관절 CT 검사 시 환자의 자세와 흡기를 통하여 검사하는 방법은 피폭선량을 최소화하고, 영상의 질을 향상하는 방법으로서 의의가 있었다고 생각한다.

Keywords

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