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Pulse wave velocity and ankle brachial index in obese adolescents (비만 청소년에서 맥파 속도와 발목 상완 동맥압 지수에 대한 연구)

  • Kim, Ji Hye;Koo, Hee Sun;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1078-1084
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    • 2007
  • Purpose : The prevalence of childhood obesity has doubled over the last 30 years. Obesity-associated sequelae in the vasculature begins in the early stages of life. The purpose of this study was to investigate how pulse wave velocity (PWV) and ankle brachial index (ABI) change with height, weight and body mass index (BMI) in obese adolescents. Methods : Seventy-nine obese adolescents (group 1: $85th{\leq}BMI<95th$ percentile, n=40; group 2 ($BMI{\geq}95th$ percentile, n=39) were included. The control group(group 3) included 99 healthy adolescents. Brachial- ankle (ba) PWV and ABI were estimated with blood pressure from four extremities. Heart rate (HR), and pre-ejection period/ejection time (PEP/ET) were also estimated. BMI was calculated from individual height and weight. Linear regression analysis was performed to evaluate the correlations between BMI and PWV. Results : Blood pressure and baPWV were significantly higher in group 2, compared to either group 1 or group 3. However, there was no significant difference in ABI, HR and PEP/ET between the groups. PWV showed linear correlation with both BMI and body weight. Conclusion : Obesity was associated with higher arterial stiffness in adolescents, which was demonstrated by an increase in PWV. There was no significant correlation between obesity and ABI.

A Report on the Shigella Cultures Isolated in Korea (1972) (1972년(年) 한국(韓國)에서 분리(分離)된 이질균(痢疾菌)에 관(關)한 보고(報告))

  • Ryu, Young-Hat;Kim, Soon-Hee
    • The Journal of the Korean Society for Microbiology
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    • v.8 no.1
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    • pp.7-11
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    • 1973
  • The authors identified eighty-eight Shigella cultures among about four thousands specimens collected from all over the country in 1972. Of eighty-eight cultures, seventy-seven cultures belonged to Shigella flexneri and eleven cultures to Shigella sonnei. None of cultures belonging to either subgroup A or C was detected in 1972. Of seventy-seven cultures of Shigella flexneri one was $B_{1b}$, fifty-six were $B_{2a}$, nine were $B_{3a}$, six were $B_{4a}$, three were By and one was each of $B_{3b}$ and $B_{3c}$. Of eleven cultures of Shigella sonnei seven cultures appeared to be phase I and the others phase II. Although there was quite a difference found in the incidence of isolating Shigella organisms between different areas as shown in Table 1, it would not be possible to understand that there might not have been the cases or carriers of Shigella in the areas where the organisms were not isolated in 1972. Concerning the biochemical properties it was not possible to compare the results obtained from the decarboxylase and dihydrolase tests with them obtained in previous years except that of lysine decarboxylase tests since they were not reported individually by the different serotypes in the previous reports. These results obtained in 1972 would be the data for the future comparison. In regards to the antibiotics-sensitivity of Shigella cultures the most of them showed sensitive results to nitrofurantoin, ampicillin, cephalosporin, gentamycin and geopen, and the majority of them appeared to be resistant to cloxacillin, tetracycline and streptomycin by means of the In Vitro tests.

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Quantitative Differences between X-Ray CT-Based and $^{137}Cs$-Based Attenuation Correction in Philips Gemini PET/CT (GEMINI PET/CT의 X-ray CT, $^{137}Cs$ 기반 511 keV 광자 감쇠계수의 정량적 차이)

  • Kim, Jin-Su;Lee, Jae-Sung;Lee, Dong-Soo;Park, Eun-Kyung;Kim, Jong-Hyo;Kim, Jae-Il;Lee, Hong-Jae;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.3
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    • pp.182-190
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    • 2005
  • Purpose: There are differences between Standard Uptake Value (SUV) of CT attenuation corrected PET and that of $^{137}Cs$. Since various causes lead to difference of SUV, it is important to know what is the cause of these difference. Since only the X-ray CT and $^{137}Cs$ transmission data are used for the attenuation correction, in Philips GEMINI PET/CT scanner, proper transformation of these data into usable attenuation coefficients for 511 keV photon has to be ascertained. The aim of this study was to evaluate the accuracy in the CT measurement and compare the CT and $^{137}Cs$-based attenuation correction in this scanner. Methods: For all the experiments, CT was set to 40 keV (120 kVp) and 50 mAs. To evaluate the accuracy of the CT measurement, CT performance phantom was scanned and Hounsfield units (HU) for those regions were compared to the true values. For the comparison of CT and $^{137}Cs$-based attenuation corrections, transmission scans of the elliptical lung-spine-body phantom and electron density CT phantom composed of various components, such as water, bone, brain and adipose, were performed using CT and $^{137}Cs$. Transformed attenuation coefficients from these data were compared to each other and true 511 keV attenuation coefficient acquired using $^{68}Ge$ and ECAT EXACT 47 scanner. In addition, CT and $^{137}Cs$-derived attenuation coefficients and SUV values for $^{18}F$-FDG measured from the regions with normal and pathological uptake in patients' data were also compared. Results: HU of all the regions in CT performance phantom measured using GEMINI PET/CT were equivalent to the known true values. CT based attenuation coefficients were lower than those of $^{68}Ge$ about 10% in bony region of NEMA ECT phantom. Attenuation coefficients derived from $^{137}Cs$ data was slightly higher than those from CT data also in the images of electron density CT phantom and patients' body with electron density. However, the SUV values in attenuation corrected images using $^{137}Cs$ were lower than images corrected using CT. Percent difference between SUV values was about 15%. Conclusion: Although the HU measured using this scanner was accurate, accuracy in the conversion from CT data into the 511 keV attenuation coefficients was limited in the bony region. Discrepancy in the transformed attenuation coefficients and SUV values between CT and $^{137}Cs$-based data shown in this study suggests that further optimization of various parameters in data acquisition and processing would be necessary for this scanner.

Immediate Reoperation for Failed Mitral Valve Repair (승모판막성형술 실패 직후에 시행한 재수술)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Se;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Wook-Sung;Lee, Young-Tak;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.929-936
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    • 2003
  • We analysed the surgical outcomes of immediate reoperations after mitral valve repair. Material and Method: Eighteen patients who underwent immediate reoperation for failed mitral valve repair from April 1995 through July 2001 were reviewed retrospectively. There were 13 female patients. The mitral valve disease was regurgitation (MR) in 12 patients, stenosis (MS) in 3, and mixed lesion in 3. The etiologies of the valve disease were rheumatic in 9 patients, degenerative in 8, and endocarditis in 1. The causes of reoperation was residual MR in 13 patients, residual MS in 4, and rupture of left ventricle in 1. Fourteen patients had rerepair for residual mitral lesions (77.8%) and four underwent replacement. Result: There was no early death. After mean follow-vp of 33 months, there was one late death. Echocardiography revealed no or grade 1 of MR (64.3%) in 9 patients and no or mild MS in 11 patients (78,6%). Reoperation was done in one patient. The cumulative survival and freedom from valve-related reoperation at 6 years were 94% and 90%, respectively. The cumulative freedom from recurrent MR and MS at 4 years were 56% and 44%, respectively. Conclusion: This study suggests that immediate reoperation for failed mitral valve repair offers good early and intermediate survival, and mitral valve rerepair can be successfully performed in most of patients. However, because mitral rerepair have high failure rate, especially in rheumatic valve disease, adequate selections of valvuloplasty technique and indication are important to reduce the failure rate of mitral rerepair.

Dosimetric Evaluation of a Small Intraoral X-ray Tube for Dental Imaging (치과용 초소형 X-선 튜브의 선량평가)

  • Ji, Yunseo;Kim, YeonWoo;Lee, Rena
    • Progress in Medical Physics
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    • v.26 no.3
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    • pp.160-167
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    • 2015
  • Radiation exposure from medical diagnostic imaging procedures to patients is one of the most significant interests in diagnostic x-ray system. A miniature x-ray intraoral tube was developed for the first time in the world which can be inserted into the mouth for imaging. Dose evaluation should be carried out in order to utilize such an imaging device for clinical use. In this study, dose evaluation of the new x-ray unit was performed by 1) using a custom made in vivo Pig phantom, 2) determining exposure condition for the clinical use, and 3) measuring patient dose of the new system. On the basis of DRLs (Diagnostic Reference Level) recommended by KDFA (Korea Food & Drug Administration), the ESD (Entrance Skin Dose) and DAP (Dose Area Product) measurements for the new x-ray imaging device were designed and measured. The maximum voltage and current of the x-ray tubes used in this study were 55 kVp, and 300 mA. The active area of the detector was $72{\times}72mm$ with pixel size of $48{\mu}m$. To obtain the operating condition of the new system, pig jaw phantom images showing major tooth-associated tissues, such as clown, pulp cavity were acquired at 1 frame/sec. Changing the beam currents 20 to $80{\mu}A$, x-ray images of 50 frames were obtained for one beam current with optimum x-ray exposure setting. Pig jaw phantom images were acquired from two commercial x-ray imaging units and compared to the new x-ray device: CS 2100, Carestream Dental LLC and EXARO, HIOSSEN, Inc. Their exposure conditions were 60 kV, 7 mA, and 60 kV, 2 mA, respectively. Comparing the new x-ray device and conventional x-ray imaging units, images of the new x-ray device around teeth and their neighboring tissues turn out to be better in spite of its small x-ray field size. ESD of the new x-ray device was measured 1.369 mGy on the beam condition for the best image quality, 0.051 mAs, which is much less than DRLs recommended by IAEA (International Atomic Energy Agency) and KDFA, both. Its dose distribution in the x-ray field size was observed to be uniform with standard deviation of 5~10 %. DAP of the new x-ray device was $82.4mGy*cm^2$ less than DRL established by KDFA even though its x-ray field size was small. This study shows that the new x-ray imaging device offers better in image quality and lower radiation dose compared to the conventional intraoral units. In additions, methods and know-how for studies in x-ray features could be accumulated from this work.

Ecosysteme de I′Etang de Berre (Mediterranee nord-occidentale) : Caracteres Generales Physiques, Chimiques et Biologiques

  • Kim, Ki-Tai
    • Korean Journal of Environmental Biology
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    • v.22 no.2
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    • pp.247-258
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    • 2004
  • Climatological, hydrological and planktonical research studies, measurements of primary production and photosynthetic efficiency from December 1976 to December 1978 have been carried out in two brackish lakes: Lake Etang de Berre and Lake Etang de Vaine located in the French Mediterranean coast, in the region of Carry-le-Rouet located on the north-west Mediterranean near Marseilles, and in fresh water inflows from 4 Rivers (Touloubre, Durance, Arc, Durancole) to Lake Etang de Berre. Physico-chemical parameters were measured for this study: water temperature, salinity, density, pH, alcalinity, dissolved oxygen (% saturation), phosphate, nitrate, nitrite, silicate etc. Diverse biological parameters were also studied: photosynthetic pigments, phaeopigments, specific composition and biomass of phytoplankton, primary pelagic production etc. Climatical factors were studied: air-temperature, solar-radiation, evaporation, direction (including strength) of winds, precipitation and freshwater volume of the four rivers. The changes in Lake ‘Etang de Berre’ ecosystem depend on the quality of the water in the Durance River, and on the effects of seawater near the entrance of the Caronte Canal. The water quality of the lake varies horizontally and vertically as a result of atmospheric phenomena, maritime currents and tides. The distribution of water temperatures is generally heterogeneous. Southeasterly winds and the Northeasterly Mistral wind are important in the origins of circulated and mixed water masses. These winds are both frequent and strong. They have, as a result, a great effect on the water environment of Lake Etang de Berre. In theory, the annual precipitation in this region is well over eight times the water mass of the lake. The water of the Durance River flows into Lake Etang de Berre through the EDF Canal, amounting to 90% of the precipitation. However, reduction of rainfall in dry seasons has a serious effect on the hydrological characteristics of the lake. The temperature in the winter is partially caused by the low temperature of fresh water, particularly that of the Durance River. The hydrological season of fresh and brackish water is about one month ahead of the hydrological season of sea water in its vicinity. The salinity of Lake Etang de Berre runs approximately 3$\textperthousand$, except at lower levels and near the entrance to the Caronte Canal. However, when the volume of the Durance River water is reduced in the summer and fall, the salinity rises to 15$\textperthousand$. In the lake, the ratio of fresh water to sea water is six to one (6:1). The large quantities of seston conveyed by rivers, particularly the Durance diversion, strongly reduce the transparency in the brackish waters. Although the amount of sunshine is also notable, transparency is slight because of the large amount of seston, carried chiefly by Tripton in the fresh water of the Durance River. Therefore, photosynthesis generally occurs only in the surface layer. The transparency progressively increases from freshwater to open seawater, as mineral particles sink to the bottom (about 1.7kg $m^{-2}a^{-1}$ on the average in brackish lakes). The concentration of dissolved oxygen and the rate of oxygen saturation in seawater (Carry-le-Rouet) ranged from 5.0 to 6.0 $m\ell$ㆍ.$1^{-1}$, and from 95 to 105%, respectively. The amount of dissolved oxygen in Etang de Berre oscillated between 2.9 and 268.3%. The monographs of phosphate, nitrate, nitrite and silicate were published as a part of a study on the ecology of phytoplankton in these environments. Horizontal and vertical distributions of these nutriments were studied in detail. The recent diversion of the Durance River into Lake Etang de Berre has effected a fundamental change in this formerly marine environment, which has had a great impact in its plankton populations. A total of 182 taxa were identified, including 111 Bacillariophyceae, 44 Chlorophyceae, and 15 Cyanophyceae. The most abundant species are small freshwater algae, mainly Chlorophyceae. The average density is about $10^{8}$ cells $1^{-1}$ in Lake Etang de Berre, and about double that amount in Lake Etang de Vaine. Differences in phytoplankton abundance and composition at the various stations or at various depths are slight. Cell biovolume V (equivalent to true biomass), plasma volume VP (‘useful’ biomass) and, simultaneously. the cell surface area S and S/V ratio through the measurement of cell dimensions were computed as the parameters of phytoplankton productivity and metabolism. Pigment concentrations are generally very high on account of phytoplankton blooms by Cyanophyceae, Chlorophyceae and Cryptophyceae. On the other hand, in freshwaters and marine waters, pigment concentrations are comparatively low and stable, showing slight annual variation. The variations of ATP concentration were closely related to those of chlorophyll a and phytoplankton blooms only in marine waters. The carbon uptake rates ranged between 38 and 1091 mg$Cm^{-2}d^{-1}$, with an average surface value of 256 mg; water-column carbon-uptake rates ranged between 240 and 2310 mg$Cm^{-2}d^{-1}$, with an average of 810, representing 290 mg$Cm^{-2}$, per year 45 000 tons per year of photosynthetized carbon for the whole lake. Gross photosynthetic production measured by the method of Ryther was studied over a 2-year period. The values obtained from marine water(Carry-le-Rouet) ranged from 23 to 2 337 mg$Cm^{-2}d^{-1}$, with a weighted average of 319, representing about 110 gCm$^{-2}$ per year. The values in brakish water (Etang de Berre) ranged from 14 to 1778 mg$Cm^{-2}d^{-1}$, with a weighted average of 682, representing 250 mg$Cm^{-2}$ per year and 38 400 tons per year of photosynthesized carbon for the whole lake.

Evaluation of Approximate Exposure to Low-dose Ionizing Radiation from Medical Images using a Computed Radiography (CR) System (전산화 방사선촬영(CR) 시스템을 이용한 근사적 의료 피폭 선량 평가)

  • Yu, Minsun;Lee, Jaeseung;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.6 no.6
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    • pp.455-464
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    • 2012
  • This study suggested evaluation of approximately exposure to low-dose ionization radiation from medical images using a computed radiography (CR) system in standard X-ray examination and experimental model can compare diagnostic reference level (DRL) will suggest on optimization condition of guard about medical radiation of low dose space. Entrance surface dose (ESD) cross-measuring by standard dosimeter and optically stimulated luminescence dosimeters (OSLDs) in experiment condition about tube voltage and current of X-ray generator. Also, Hounsfield unit (HU) scale measured about each experiment condition in CR system and after character relationship table and graph tabulate about ESD and HU scale, approximately radiation dose about head, neck, thoracic, abdomen, and pelvis draw a measurement. In result measuring head, neck, thoracic, abdomen, and pelvis, average of ESD is 2.10, 2.01, 1.13, 2.97, and 1.95 mGy, respectively. HU scale is $3,276{\pm}3.72$, $3,217{\pm}2.93$, $2,768{\pm}3.13$, $3,782{\pm}5.19$, and $2,318{\pm}4.64$, respectively, in CR image. At this moment, using characteristic relationship table and graph, ESD measured approximately 2.16, 2.06, 1.19, 3.05, and 2.07 mGy, respectively. Average error of measuring value and ESD measured approximately smaller than 3%, this have credibility cover all the bases radiology area of measurement 5%. In its final analysis, this study suggest new experimental model approximately can assess radiation dose of patient in standard X-ray examination and can apply to CR examination, digital radiography and even film-cassette system.

Sputtering방식을 이용한 Indium Thin oxide박막의 넓이에 따른 X-ray 검출기 특성 연구

  • Kim, Dae-Guk;Sin, Jeong-Uk;O, Gyeong-Min;Kim, Seong-Heon;Lee, Yeong-Gyu;Jo, Seong-Ho;Nam, Sang-Hui
    • Proceedings of the Korean Vacuum Society Conference
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    • 2012.02a
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    • pp.321-322
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    • 2012
  • 의료용 방사선 장비는 초기의 아날로그 방식의 필름 및 카세트에서 진보되어 현재는 디지털 방식의 DR (Digital Radiography)이 널리 사용되며 그에 관한 연구개발이 활발히 진행되고 있다. DR은 크게 간접방식과 직접방식의 두 분류로 나눌 수 있는데, 간접방식은 X선을 흡수하면 가시광선으로 전환하는 형광체(Scintillator)를 사용하여 X선을 가시광선으로 전환하고, 이를 Photodiode와 같은 광소자로 전기적 신호로 변환하여 방사선을 검출하는 방식을 말하며, 직접 방식은 X선을 흡수하면 전기적 신호를 발생 시키는 광도전체(Photoconductor)를 사용하여 광도전체 양단 전극에 고전압을 인가한 형태를 취하고 있는 가운데, X선이 조사되면 일차적으로 광도전체 내부에서 전자-전공쌍(Electron-hole pair)이 생성된다. 이들은 광도전체 양단의 인가되어 있는 전기장에 의해 전자는 +극으로, 전공은 -극으로 이동하여 아래에 위치한 Active matrix array을 통해 방사선을 검출하는 방식이다. 본 연구에서는 직접방식 X-ray 검출기에서 활용되는 a-Se을 ITO (Indium Thin oxide) glass 상단에 Thermal evaporation증착을 이용하여 두께 $50{\mu}m$, 33 넓이로 증착 시킨 다음, a-Se상단에 Sputtering증착을 이용하여 ITO를 11 cm, 22 cm, $2.7{\times}2.7cm$ 넓이로 증착시켜 상하부의 ITO를 Electrode로 이용하여 직접방식의 X-ray검출기 샘플을 제작하였다. 제작 과정 중 a-Se의 Thermal evaporation증착 시, 저진공 $310^{-3}_{Torr}$, 고진공 $2.210^{-5}_{Torr}$에서 보트의 가열 온도를 두 번의 스텝으로 나누어 증착 시켰다. 첫 번째 스텝 $250^{\circ}C$, 두 번째 스텝은 $260^{\circ}C$의 조건으로 증착하여 보트 내의 a-Se을 남기지 않고 전량을 소모할 수 있었으며, 스텝간의 온도차를 $10^{\circ}C$로 제어하여 균일한 박막을 형성 할 수 있었다. Sputtering증착 시, 저진공 $2.510^{-3}$, 고진공 $310^{-5}$에서 Ar, $O_2$를 사용하여 100 Sec간 플라즈마를 생성시켜 ITO를 증착하였다. 제작된 방사선 각각의 검출기 샘플 양단의 ITO에 500V의 전압을 인가하고, 진단 방사선 범위의 70 kVp, 100 mA, 0.03 sec 조건으로 X-ray를 조사시켜 ITO넓이에 따른 민감도(Sensitivity)와 암전류(Dark current)를 측정하였다. 측정결과 민감도(Sensitivity)는 X-ray샘플의 두께에 따른 $1V/{\mu}m$ 기준 시, 증착된 ITO의 넓이가 11 cm부터 22 cm, $2.7{\times}2.7cm$까지 각각 $7.610nC/cm^2$, $8.169nC/cm^2$, $6.769nC/cm^2$로 22 cm 넓이의 샘플이 가장 높은 민감도를 나타내었으나, 암전류(Dark current)는 $1.68nA/cm^2$, $3.132nA/cm^2$, $5.117nA/cm^2$로 11 cm 넓이의 샘플이 가장 낮은 값을 나타내었다. 이러한 데이터를 SNR (Signal to Noise Ratio)로 합산 하였을 시 104.359 ($1{\times}1$), 60.376($2{\times}2$), 30.621 ($2.7{\times}2.7$)로 11 cm 샘플이 신호 대 별 가장 우수한 효율을 나타냄을 알 수 있었다. 따라서 ITO박막의 면적이 클수록 민감도는 우수하나 그에 따른 암전류의 증가로 효율이 떨어짐을 검증 할 수 있었으며, 이는 ITO면적이 넓어짐에 따른 저항의 증가로 암전류에 영향을 끼침을 할 수 있었다. 본 연구를 통해 a-Se의 ITO 박막 면적에 따른 전기적 특성을 검증할 수 있었다.

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A Study on the Change of Image Quality According to the Change of Tube Voltage in Computed Tomography Pediatric Chest Examination (전산화단층촬영 소아 흉부검사에서 관전압의 변화에 따른 화질변화에 관한 연구)

  • Kim, Gu;Kim, Gyeong Rip;Sung, Soon Ki;Kwak, Jong Hyeok
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.503-508
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    • 2019
  • In short a binary value according to a change in the tube voltage by using one of VOLUME AXIAL MODE of scanning techniques of chest CT image quality evaluation in order to obtain high image and to present the appropriate tube voltage. CT instruments were GE Revolution (GE Healthcare, Wisconsin USA) model and Phantom used Pediatric Whole Body Phantom PBU-70. The test method was examined in Volume Axial mode using the pediatric protocol used in the Y university hospital of mass-produced material. The tube voltage was set to 70kvp, 80kvp, 100kvp, and mAs was set to smart mA-ODM. The mean SNR difference of the heart was $-4.53{\pm}0.26$ at 70 kvp, $-3.34{\pm}0.18$ at 80 kvp, $-1.87{\pm}0.15$ at 100 kvp, and SNR at 70 kvp was about -2.66 higher than 100 kvp and statistically significant (p<0.05) In the Lung SNR mean difference analysis, $-78.20{\pm}4.16$ at 70 kvp, $-79.10{\pm}4.39$ at 80 kvp, $-77.43{\pm}4.72$ at 100 kvp, and SNR at 70 kvp at about -0.77 higher than 100 kvp were statistically significant. (p<0.05). Lung CNR mean difference was $73.67{\pm}3.95$ at 70 kvp, $75.76{\pm}4.25$ at 80 kvp, $75.57{\pm}4.62$ at 100 kvp and 20.9 CNR at 80 kvp higher than 70 kvp and statistically significant (p<0.05) At 100 kvp of tube voltage, the SNR was close to 1 while maintaining the quality of the heart image when 70 kvp and 80 kvp were compared. However, there is no difference in SNR between 70 kvp and 80 kvp, and 70 kvp can be used to reduce the radiation dose. On the other and, CNR showed an approximate value of 1 at 70 kvp. There is no difference between 80 kvp and 100 kvp. Therefore, 80 kvp can reduce the radiation dose by pediatric chest CT. In addition, it is possible to perform a scan with a short scan time of 0.3 seconds in the volume axial mode test, which is useful for pediatric patients who need to move or relax.