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Effects of Radiation Dose and Image Quality at the Coronary Angiography

관상동맥검사에서 선량과 화질에 관한 연구

  • 류명송 (동신대학교 방사선학과) ;
  • 최남길 (동신대학교 방사선학과) ;
  • 한재복 (동신대학교 방사선학과) ;
  • 양숙 (동신대학교 방사선학과) ;
  • 이종호 (화순전남대학교병원 영상의학과)
  • Received : 2012.02.16
  • Accepted : 2012.03.27
  • Published : 2012.04.28

Abstract

The aim of this study was to assess the effect of exposure factors such as kVp and mA applied by BMI on the image quality and patients absorbed dose of Coronary angiography in CT. Each data sets were into 4groups with different exposure values : Group A at 100kVp, 240mAs, Group B at 120kVp, 240mAs, Group C at 100kVp, 270mAs and Group D at 120kVp, 270mAs, and the mean of the scores of 4 groups was calculated for image quality as 4grades that is, 1(poor), 2(fair), 3(good) and 4(very good). Patient absorbed dose was calculated as DLP on the monitor. In case of absorbed dose, deviation in 2groups at 100kVp was 5.6 $mGy{\cdot}cm$, 11 $mGy{\cdot}cm$, was at 120kVp(DLP) with p<0.05. There was rather difference between groups with 100kVp or 120kVp respectively but the gaps were very little. No significant correlation was found between exposure factors and image quality in any images assessed(p>0.05), and the image quality was sufficient for diagnosis. As we applying coronary angiography, the selection of adequate exposure factors considering BMI identified might be effective for reduction of patient absorbed dose, improvement of image quality and diagnostic accuracy.

본 연구는 체질량지수에 따른 관전압(kVp)과 관전류량(mAs)의 변화에서 선량과 화질의 연관성을 알아보고자 하였다. 실험대상군은 A군(100 kVp, 240 mAs, N=20), B군(120 kVp, 240 mAs, N=20), C군(100 kVp, 270 mAs, N=20), D군(120 kVp, 270 mAs, N=20)으로 나누어 관전류량의 변화에 관계된 화질을 평가하였다. 실험대상군에 대한 화질평가는 4점 척도를 사용하여 very good 4점, good 3점, fair 2점, poor 1점 등급으로 나누어 평가하였고, 피폭선량은 DLP(dose length product)를 이용하여 평가하였다. 결론적으로 100 kVp에서는 5.6 $mGy{\cdot}cm$, 120 kVp에서는 11 $mGy{\cdot}cm$, 정도 낮은 선량을 보였고 통계적으로 유의한 차이를 보였다(p<0.05). 하지만 화질평가에서도 통계적으로 유의한 차이가 없었으며 진단적 가치가 동등한 영상을 획득하였다(p>0.05). 따라서 CT 관상동맥조영술 검사에서는 사전에 체질량지수(body mass index)을 고려하여 검사조건을 적절하게 선택하는 것이 환자의 피폭선량을 줄이면서 최적의 화질을 획득할 수 있을 것이라 사료된다.

Keywords

References

  1. 김영근, 김문찬, 임청환 , 전산화단층촬영 영상학, 청구문화사, pp.150-167, 1997.
  2. 이활, "CT관상동맥 조영술의 기술적 측면 : 검사기법과 안전성", J Korean Medical Association, Vol.104, 2007.
  3. N. R. Mollet, F. Cardemartiri, C. A. van Mieghem, G. Runza, E. P. McFadden, and T. Baks, "High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography," Circulation, Vol.112, pp.2318-2323, 2005. https://doi.org/10.1161/CIRCULATIONAHA.105.533471
  4. S. Leschka, H. Alkadhi, A. Plass, L. Desbiolles, J. Grunenfelder, and B. Marincek, "Accuracy of MSCT coronary angiography with 62-slice technology," first experience e.Eur Heart J, Vol.26, pp.1482-1487, 2005. https://doi.org/10.1093/eurheartj/ehi261
  5. L. Husmann, T. Schepis, H. Scheffel, O. Gaemperli, S. Leschka, I. Valenta, "Comparison of diagnostic accuracy of 64-slice computed tomography coronary angiography in patients with low, intermediate, and high cardiovascular risk," Academy Radiology, Vol.15, pp.452-461, 2008. https://doi.org/10.1016/j.acra.2007.12.008
  6. J. Hausleiter, T. Meyor, M. Hadamitzky, E. Huber, M. Zankl, and S. Martinoff, "Radiation dose estimates from cardiac multislice computed tomography in dail practice: impact of different scanning protocols on effective dose estimates," Circulation, Vol.113, pp.1305-1310, 2006. https://doi.org/10.1161/CIRCULATIONAHA.105.602490
  7. S. Leschka, P. Stolzmann, F. T. Schmid, H. Scheffel, B. Stinn, and B. Marincek, "Low kilovoltage cardiac dual-source CT : attenuation, noise, and radiation dose," European Radiology, Vol.18, pp.1809-1817, 2008. https://doi.org/10.1007/s00330-008-0966-1
  8. Z. Szucs-Farkas, L Kurmann, T. Strautz, M. A. Patak, P. Vock, and S. T. Schindera, "Patient exposure and image quality of low-dose pulmonary computed tomography angiography: comparison of 100-kVp and 80-kVp protocols," Investment Radiology, Vol.43, pp.871-876, 2008. https://doi.org/10.1097/RLI.0b013e3181875e86
  9. P. Stolzmann, S. Leschka, H. Scheffel, T. Krass, L. Desbiolles, and A. Plass, "Dual source CT in step-and-shoot mode : noninvasive coronary angiography with low radiation dose," Radiology, Vol.249, pp.71-80, 2008. https://doi.org/10.1148/radiol.2483072032
  10. H. Alkachi, P. Stolzmann, H. Scheffel, L. Desbiolles, S. Bau¨muller, and A. Plass, "Radiation dose of cardiac dual-source CT : the effect of tailoring the portocol to patient-specific parameters," European J Radiology, Vol.68, pp.385-391, 2008. https://doi.org/10.1016/j.ejrad.2008.08.015
  11. F. Tatsugami, L. Husmann, B. A. Herzog, N. Burkhard, I. Valenta, O. Gaemperli, "Evaluation of a body mass index-adapted protocol for low-dose 64-MDCT coronary angiography with prospetive ECG triggering," AJR Am J Roentgenol, Vol.192, pp.635-638, 2009. https://doi.org/10.2214/AJR.08.1390
  12. 김윤경, 김유경, "체질량지수 및 관전압 변화에 따른 CT 관상동맥 조영술의 영상의 질 및 방사선 피폭량 비교", 대한영상의학회지, Vol.62, pp.29-35, 2010.