• Journal of Periodontal and Implant Science
• /
• 제48권5호
• /
• pp.317-325
• /
• 2018

Purpose: We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations. Methods: This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009-2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses. Results: The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography. Conclusions: Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.

• 한국콘텐츠학회논문지
• /
• 제11권2호
• /
• pp.322-330
• /
• 2011

전국 33개 진폐요양기관 흉부 방사선분야 정도관리 실태조사를 실시하여 정밀/요양기관(17개)과 요양기관(16개)에 대해 산업안전보건연구원 진폐정도관리 평가표를 이용하여 촬영기술, 판독환경 및 화질평가 결과를 비교 분석하였다. 촬영기술과 판독환경은 연구자가 직접방문하여 평가하였고, 화질평가는 각 진폐 요양기관에서 보내온 영상을 기관마다 10장씩 무작위추출하여 2명의 흉부 영상의학과 전문의가 영상에 대한 어떤 정보도 모르는 상태에서 개별적으로 실시하였다. 정밀/요양기관과 요양기관 사이, 흉부 방사선 촬영 장치의 성능, 사용기간, 촬영방법에서는 유의한 차이가 없었지만, 단순 흉부 촬영조건에서 관전압과 그리드 비에서 유의한 차이가 있었다. 또한, 촬영기술과 판독환경평가에서는 정밀/요양기관이 요양기관 보다 유의하게 높았고, 화질평가에서도 높았지만 유의한 차이는 없었다. 따라서, 진폐합병증이 있는 요양환자의 신뢰성있고 정확한 진단을 위해서는 요양기관의 흉부 방사선분야 정도관리 향상을 위한 외부평가 및 교육이 필요하다.

• 대한방사선기술학회지:방사선기술과학
• /
• 제38권4호
• /
• pp.395-401
• /
• 2015

영상의학과의 흉부엑스선 검사에서 감염관리에 대한 기기의 오염 정도를 세균학적으로 확인하고 균을 동정하여 병원감염의 예방과 감염관리방안을 마련하는데 목적이 있다. 영상의학과 흉부 엑스선 검사에서 환자의 기기 접촉부위인 어깨, 손, 턱, 흉부 측면촬영의 손잡이 부위를 70% 이소프로필 알코올로 소독하기 전과 후를 면봉으로 검체를 채취하여 세균을 동정하여 비교하여 분석하였다. 흉부 엑스선 기기에서 소독전의 측면촬영의 손잡이에서 그람 양성의 Staphylococcus가 분리되었다. 최종동정을 위해 노보바이오신 (nobobiocin) 항생제 시험을 실시하여 민감성으로 Staphylococcus epidermidis로 확정하였다. 흉부촬영 기기에서 측면촬영의 손잡이 부위를 소독 전에 Staphylococcus epidermidis 균이 검출되었다. 흉부엑스선 검사에서 기기를 주기적인 소독 및 멸균을 실시하여 병원감염을 예방하는 관리방안을 마련하여야 한다.

• Imaging Science in Dentistry
• /
• 제42권4호
• /
• pp.237-242
• /
• 2012

Purpose: The objectives of this study were to survey the radiographic exposure parameters, to measure the patient doses for intraoral dental radiography nationwide, and thus to establish the diagnostic reference levels (DRLs) in intraoral dental X-ray examination in Korea. Materials and Methods: One hundred two intraoral dental radiographic machines from all regions of South Korea were selected for this study. Radiographic exposure parameters, size of hospital, type of image receptor system, installation duration of machine, and type of dental X-ray machine were documented. Patient entrance doses (PED) and dose-area products (DAP) were measured three times at the end of the exit cone of the X-ray unit with a DAP meter (DIAMENTOR M4-KDK, PTW, Freiburg, Germany) for adult mandibular molar intraoral dental radiography, and corrections were made for room temperature and pressure. Measured PED and DAP were averaged and compared according to the size of hospital, type of image receptor system, installation duration, and type of dental X-ray machine. Results: The mean exposure parameters were 62.6 kVp, 7.9 mA, and 0.5 second for adult mandibular molar intraoral dental radiography. The mean patient dose was 2.11 mGy (PED) and 59.4 $mGycm^2$ (DAP) and the third quartile one 3.07 mGy (PED) and 87.4 $mGycm^2$ (DAP). Doses at university dental hospitals were lower than those at dental clinics (p<0.05). Doses of digital radiography (DR) type were lower than those of film-based type (p<0.05). Conclusion: We recommend 3.1 mGy (PED), 87.4 $mGycm^2$ (DAP) as the DRLs in adult mandibular molar intraoral dental radiography in Korea.

• Imaging Science in Dentistry
• /
• 제37권2호
• /
• pp.83-86
• /
• 2007

Purpose : To evaluate the efficacy of panoramic radiography by comparing the results of clinical examination with radiographic findings. Materials and Methods: We studied 190 patients (20 men and 170 women; mean age, 40 years; range, 22 to 68 years) who visited the health promotion center of Korea Medical Science Institute and were examined both clinically and by panoramic radiography. We compared results from both examinations. Treatment options by clinical examination were described as "no treatment indicated", "treatment of dental caries", "removal of calculus", "treatment of periodontal disease", "prothodontic treatment" and "extraction of the third molar". Findings taken from the panoramic radiography were: dental caries, periapical lesion, alveolar bone loss, calculus deposition, retained root, impaction of the third molar, disease of maxillary sinus, bony change of mandibular condyle, etc. Results: The prevalence of panoramic findings were: 37.9% of dental caries, 17.4% of periapical lesions, 44.7% of alveolar bone losses, 62.6% of calculi deposition, 7.9% of retained roots, 26.8% of third molar impactions, 6.3% of diseases of maxillary sinus, 2.1 % of bony changes of mandibular condlye and 35.8% of miscellaneous lesions. Abnormal conditions revealed by panoramic radiography which had not been discovered on clinical examination were: 24.2% of the patients had dental caries, 17.4% had periapical lesions, 7.4% had calculi deposition, 5.3% had retained roots, 15.3% had third molar impactions. The opposite cases were: 5.2% had dental caries, 12.6% had calculi deposition, and 9.5% had third molar impactions. Conclusion: The use of panoramic radiography as a supplement to the clinical examination might be a valuable screening technique.

• 대한안전경영과학회지
• /
• 제13권2호
• /
• pp.91-96
• /
• 2011

The purpose of this study was to minimize of entrance surface dose (ESD) at the eye using high kVp technique in the computed radiography. We used REX-650R (Listem, Korea) general X-ray unit, and external detector with ESD dosimeter of Piranha 657 (RTI Electronics, Sweden). We used head of the whole body phantom. The total 64 images of X-ray anterior-posterior of skull were acquired using the film/screen (F/S) method and the digital of computed radiography method. The three radiology professor of more 10 years of clinical career evaluated a X-rays images in the same space by 5-point scale. The external detector was performed measurement of ESD of three times by same condition on the eye of the head phantom. The good image quality in the F/S method (90 kVp, 2.5 mAs) showed at the minimized ESD of 0.310 ${\pm}$ 0.001 mGy. the good image quality in the computed radiography method (90 kVp, 2.0 mAs) showed at the minimized ESD of 0.180 ${\pm}$ 0.002 mGy (P = 0.002). Finally the radiation dose could reduced about 50% in the computed radiography method more than the F/S method. In addition the eye entrance surface dose using high kVp technique with the computed radiography was reduced 92% more than conventional technique (F/S method).

• Imaging Science in Dentistry
• /
• 제49권2호
• /
• pp.115-122
• /
• 2019

Purpose: The aims of this study were first, to compare panoramic radiography with cone-beam computed tomography (CBCT) for evaluating topographic relationships, such as the classification of maxillary posterior teeth and their distance to the maxillary sinus floor; and second, to determine the relationship between maxillary sinus pathology and the presence of apical lesions. Materials and Methods: In total, 285 paired CBCT and panoramic radiography records of patients (570 maxillary sinuses) were retrospectively analyzed. Both imaging modalities were used to determine the topographic relationship of the maxillary posterior teeth to the sinus floor. Mucosal thickening >2 mm was considered a pathological state. Data were analyzed using the chi-square, Wilcoxon, and Mann-Whitney U tests. Odds ratios (ORs) and confidence intervals(CIs) were calculated. Results: The closest vertical distance measurements made between posterior maxillary teeth roots and the maxillary sinus on panoramic radiography and CBCT scans showed statistically significant differences from each other(P<0.05). Compared to panoramic radiography, CBCT showed higher mean values for the distance between the maxillary sinus floor and maxillary posterior teeth roots. The CBCT images showed that at least 1 apical lesion adjacent to the right maxillary sinus increased the risk of maxillary sinus pathology by 2.37 times(OR, 2.37; 95% CI, 1.58-3.55, P<0.05). Conclusion: Panoramic radiography might lead to unreliable diagnoses when evaluating the distance between the sinus floor and posterior roots of the maxillary teeth. Periapical lesions anatomically associated with maxillary sinuses were a risk factor for sinus mucosal thickening.

• 대한방사선협회지
• /
• 제29권1호
• /
• pp.263-263
• /
• 2003

• 전자공학회논문지
• /
• 제50권12호
• /
• pp.247-253
• /
• 2013

본 연구의 목적은 Direct DR(Digital Radiography), Indirect DR, I.I(Image Intensifier) DR에서 X선 광자 검출 방식에 따른 선량측정 및 획득된 영상을 정량적이고 객관적인 측정을 통해 DR System을 비교 평가 하는 것이다. Rando phantom을 사용하여 입사표면선량을 측정하였으며, 측정된 입사표면선량 값을 통해 PCXMC 프로그램을 사용하여 유효선량과 방사선 조사로 인한 위험을 평가하였다. 21cm 아크릴 phantom을 사용하여 SNR(Signal to Noise Ratio), NPS(Noise Power Spectrum), CNR(Contrast to Noise Ratio)을 측정하였으며, 측정값은 통계학적 분석기법을 사용하여 유의성을 평가하였다. 입사표면선량, 주요장기선량, 유효선량 모두 direct DR이 가장 낮게 측정되었으며, direct DR 선량을 기준으로 I.I type DR은 약 1.3배, indirect DR은 약 2.4배 높은 선량 비율로 측정되었다. 방사선량에 따른 위험도 역시 동일한 비율로 측정되었다. SNR 측정 결과 direct DR측정값을 기준으로 I.I DR은 약 7.25배, indirect DR이 약 1.48배 낮은 비율로 측정되었다. CNR 측정 결과 direct DR 측정값을 기준으로 I.I DR은 약 1.16배 높고, indirect DR이 약 0.87배 낮은 비율로 측정되었다. 따라서 a-selenium 검출소자를 사용하여 X선 광자를 검출하는 방식인 direct DR은 적은 선량으로 우수한 화질의 영상을 구현함으로써 선량에 민감한 소아나 생식선이 포함된 검사 등에 유용할 것으로 사료된다. 또한 많은 진단 정보를 위한 영상 평가가 요구되는 경우에는 indirect DR이 유용할 것으로 판단된다.

• 한국방사선학회논문지
• /
• 제5권6호
• /
• pp.343-349
• /
• 2011

치과 방사선검사에 있어 두부 내의 흡수선량에 관한 평가를 하고자 인체모형팬텀 내부의 뇌하수체와 안구, 상악동, 악하선, 갑상선, 식도에 유리형광소자를 삽입하고 X-선을 조사하였다. 사용된 장치로는 Kodak 2200, Kodak 8000C dental radiographic systems과 computed tomography(Lightspeed VCT)이고 촬영조건은 임상에서 사용하는 인자와 동일하게 설정하였다. 이때 구내 X-선 검사의 경우 흡수선량은 0.02~2.47cGy로 가장 높게 측정된 곳은 상악 대구치 촬영 시 2.47cGy인 갑상선이었고 가장 낮은 곳은 하악 전치부 촬영에서 0.02cGy인 악하선이었다. 그리고 구외 X-선 검사의 경우 흡수선량은 세파로에서 0.36~3.44cGy, 파노라마에서 0.14~12.82cGy, 전산화단층촬영에서 8.17~253.63cGy 가장 높게 측정된 곳은 상악 CT 촬영 시 253.63cGy인 악하선이었고 가장 낮은 곳은 파노라마 촬영에서 0.14cGy인 안구이었다. 구외 X-선 검사가 구내 X-선 검사 보다 많은 흡수선량이 측정되었다. 특히 CT를 이용한 검사에서는 구내 촬영보다 100배 이상 높게 측정되었다. 따라서 구외 X-선 검사에 있어서 가이드라인을 제시하여야 하며 방사선에 의한 흡수선량을 줄이기 위한 노력이 요구된다.