DOI QR코드

DOI QR Code

The Image Distortion Analysis of Levin-tube tip by Patient position and Incidence Angle when taking Mobile Chest AP Projection

Mobile Chest AP 검사 시 환자자세와 입사각도에 따른 Levin-tube tip의 영상왜곡 분석

  • Lee, Jinsoo (Dept. of Radiology, Inje University Haeundae Paik Hospital) ;
  • Park, Hyonghu (Dept. of Radiological Science, International University of Korea)
  • 이진수 (인제대학교 해운대백병원 영상의학과) ;
  • 박형후 (한국국제대학교 방사선학과)
  • Received : 2015.10.16
  • Accepted : 2015.12.25
  • Published : 2015.12.31

Abstract

This study's purpose is improve image quality to keep accurate tube angle in order to recognize distortion degree conditions by patient's position or tube angle and to provide exact clinical informations when taking chest AP projection for patient which have L-tube in stomach. The experimental equipment was ELMO-T6S by SHIMADZU corporation, then we put L-tube which attached 1 mm gap scales ruler on chest phantom surface. The experiment set by 90 kVp, 4 mAs, 120 cm distance. Each phantom position which changed supine, 30degree, 45degree, 60degree on the table exposured direct, ${\pm}5degree$, ${\pm}10degree$, ${\pm}15degree$ to head and feet directions. As a result, L-tube tip's position was changed by patient's position and tube angle. When patient's position is supine, tip's position change was lower than 30degree, 45degree, 60degree. We have to adjust patient's position or tube angle in order to occur image distortion by fault tube angle when confirming correct position L-tube tip through chest x-ray. Also, Radiological technologist try to make accurate evaluation index for satisfied L-tube insertion.

본 연구에서는 L-tube insertion 환자의 흉부 AP 검사 시 tube tip이 환자의 자세나 방사선 조사각에 의해 왜곡되는 정도를 파악하고 정확한 임상정보를 제공하기 위해 검사 시 정확한 tube 각도를 유지하여 영상의 질을 높이고자 하는데 있다. 실험 장비로 SHIMADZU사의 ELMO-T6S를 사용하였으며, Chest phantom의 표면에 1 mm 간격의 눈금격자를 부착한 L-tube를 부착하여 실험을 하였다. 실험영상의 영상 획득 조건은 90 kVp, 4 mAs, SSD 120 cm로 하여 영상을 획득하였다. Phantom position은 table에서 supine, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$로 변화시키고 각 position마다 Head 방향과 Feet 방향으로 수직, ${\pm}5^{\circ}$, ${\pm}10^{\circ}$, ${\pm}15^{\circ}$ 촬영을 하여 영상을 획득하였다. 본 실험 결과로 L-tube tip의 위치는 환자의 자세와 방사선 입사각에 따라 달라지며 환자의 position이 30, 45, $60^{\circ}$일 때 보다 supine 일 때 tip의 위치변화가 적은 것으로 나타났다. 흉부 방사선 검사를 통해 L-tube tip의 정확한 위치를 보고자 할 때 잘못 된 입사각에 의한 영상의 왜곡이 발생하지 않도록 환자의 자세나 입사각을 조정해야 하며, 해당 시술을 확인하는데 정확한 평가 지표로 이용될 수 있도록 임상에서 업무를 수행하는 방사선사들의 세심한 노력이 필요할 것으로 사료된다.

Keywords

References

  1. J. K. Im, K. S. Lee, "Thoracic Radiology Science", Ilchokak Publishing, pp.29-34, 2000.
  2. J. Y. Seo, "Acute Respiratory Failure and Interpretation of Chest Radiography in the Intensive Care Unit", J Neurocrit Care, Vol. 2012, No. 5, pp.17-20, 2012.
  3. Ashizawa. K, Nippon. Igaku, Hoshasen. Gakkai. Zasshi, "Role and limitation of plain radiography in Chest", Radiology, Vol. 63, No. 4, pp.140-147, 2003.
  4. J. H. Yoon, D. H. Lee, "A Comparison of Hemodynamic Changes after Endotracheal Intubation by using the Bonfils Intubation Fibrescope and the Laryngoscope", Korean Journal of Anesthesiology, Vol. 51, No. 5, pp.547-551, 2006. https://doi.org/10.4097/kjae.2006.51.5.547
  5. D. H. Lee, H. S. Do, "The effectiveness of the Bonfils intubation fibrescope for endotracheal intubation", Korean Journal of Anesthesiology, Vol. 55, No. 1, pp.36-39, 2008. https://doi.org/10.4097/kjae.2008.55.1.36
  6. S. C. Lee, J. C. Son, B. G. Lee, "The Depth of Double Lumen Endobronchial Tube and the Effect of Lateral Decubitus Position to the Depth in Korean Adult Patients", Korean Journal of Anesthesiology, Vol. 32, No. 3, pp.390-396, 1997. https://doi.org/10.4097/kjae.1997.32.3.390
  7. Y. S. Yoon et al., "Proper Depth of Tracheal Intubation in Korean Children", The Korean Society of Emergency Medicine, Vol. 13, No. 3, pp.319-323, 2002.
  8. H. K. Kim et al., "Original Articles : The Availability of Bedside Ultrasonography in Confirming Endotracheal Tube Placement in the Emergency Department ", The Korean Society of Emergency Medicine, Vol. 18, No. 3, pp.227-233, 2007.
  9. G. S. Kim, W. I. Choi, "Rapid Confirming Method of Endotracheal Intubation", Korean Journal of Anesthesiology, Vol. 27, No. 6, pp.571-575, 1994. https://doi.org/10.4097/kjae.1994.27.6.571
  10. G. R Choi, "Rapid Confirming Method of Endotracheal Intubation", Journal of Korean Society of Radiology , Vol. 7, No. 3, pp.233-238, 2007. https://doi.org/10.7742/jksr.2013.7.3.233
  11. H. Y Ahn, "degree of pain caused by foley catheter and levin tube insertion", Department of Emergency Medicine, School of Medicine Kyung Hee University, pp.1-27, 2013.