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이인욱(In-Uk Lee),최재성(Jae-Seong Choi),이선표(Seon-Pyo Lee),이현성(Hyeon-Seong Lee) 대한CT영상기술학회 2023 대한CT영상기술학회지 Vol.25 No.2
출혈성 뇌졸중 환자의 뇌혈관 CT(Brain CTA) 검사 시 관심영역(ROI) 위치 및 검사 지연시간(Scan delay time) 변경을 통하여 뇌혈관의 조영증강 최적화를 위한 검사방법을 알아보고자 하였다. 2022년 9월부터 2023년 2월까지 본원 응급실에 내원하여 Brain CTA 검사를 시행한 환자 80명을 대상으로 질환이 없는 대조군 그룹 10명을 C3~4 level에 ROI를 설정하고 육안으로 총경동맥(Common carotid artery)에 조영증강이 되는 즉시 6초 delay 후 검사를 시행하였고, 출혈성 뇌졸중 실험군 A그룹 40명은 대조군과 같은 검사방법으로 설정하고 10명씩 A-0; 6초, A-1; 8초, A-2; 10초, A-3; 12초 delay 후 검사를 시행하였으며, 출혈성 뇌졸중 실험군 B그룹 30명은 대뇌동맥고리(Circle of willis) level에 ROI를 설정하고 10명씩 중대뇌동맥(Middle cerebral artery; MCA)에 조영증강이 되는 즉시 B-1; 2초, B-2; 4초, B-3; 6초 delay 후 검사를 시행하였다. 평가방법으로는 대조군 그룹과 실험군 A, B그룹의 내경동맥(Internal carotid artery), MCA, 상시상정맥동(Superior sagittal sinus; SSS), 내경정맥(Internal jugular vein)의 조영증강 정도(Mean HU)값과 백분율 값을 구하여 비교 분석한 정량적 평가와 재구성 영상을 통한 정성적 평가, 그리고 독립표본 t-검정을 이용한 유의성 평가를 진행하였다. 정량적 평가 결과 실험군 그룹에서 MCA의 Mean HU값은 대조군 그룹의 369HU보다 낮게 측정되었지만, 전체적으로 300HU에 근접한 값으로 나타났다. MCA vs SSS 백분율 값에서 실험군 B-2 그룹이 0.7%로 대조군 그룹과 가장 근접한 값으로 나타났다. 정성적 평가로 재구성 영상을 통한 Blind test 결과 대조군 그룹이 16점으로 가장 높았으며, 실험군에서는 B-2 그룹이 15점으로 가장 높았다. 독립표본 t-검정을 통한 유의성 평가 결과 대조군 그룹과 실험군 B-2 그룹의 p-value는 0.408로 유의한 차이가 없는 것으로 평가되었고, 그 외 실험군 그룹에서는 유의한 차이가 있는 것으로 평가되었다. 질환이 없는 대조군 그룹과 출혈성 뇌졸중이 있는 실험군 A, B 그룹을 ROI 위치와 Scan delay time을 변경하여 시행한 검사를 분석한 결과 대뇌동맥고리 level에 ROI를 설정하고, MCA에 조영증강이 되는 즉시 4초 delay 후 검사하는 방법이 출혈성 뇌졸중 환자의 Brain CTA 검사에 유용할 것으로 사료된다. During the brain computed tomography angiography (Brain CTA) test of hemorrhagic stroke patients, we tried to find out the test method for optimizing contrast enhancement of cerebrovascular vessels by changing the location of the region of interest (ROI) and scan delay time. From September 2022 to February 2023, 80 patients who visited the emergency room and performed a Brain CTA test were tested, and 10 people in control group without disease were ROI set at C3 to C4 level and performed a test by 6-second delay scan as soon as contrast enhancement was performed on common carotid artery (CCA) with the naked eye. 40 people in the hemorrhagic stroke experiment group A setting the same test method as the control group were tested after A-0; 6 second, A-1; 8 second, A-2; 10 second, A-3; 12-second delay for 10 people each, and 30 people in experiment group B setting ROI at circle of willis level and as soon as contrast enhancement was performed in the middle cerebral artery (MCA) were tested after B-1; 2 second, B-2; 4 second, B-3; 6-second delay for 10 people each. The evaluation methods include quantitative evaluation that compares and analyzes the mean HU values and percentage values of internal carotid artery (ICA), MCA, superior sagittal sinus (SSS), and internal jugular vein (IJV) of the control group and experimental groups A and B, qualitative evaluation through reconstructed images, and significance evaluation was conducted using an independent sample t-test. As a result of the quantitative evaluation, the mean HU value of MCA in the experimental group was measured lower than that of the control group, 369 HU, but was generally close to 300 HU. In the MCA vs SSS percentage value, the experimental group B-2 was 0.7%, the closest value to the control group. As a result of the blind test through reconstructed images as a qualitative evaluation, the control group scored the highest with 16 points, and in the experimental group B-2 scored the highest with 15 points. As a result of significance evaluation through an independent sample t-test, the p-value of the control group and the experimental group B-2 was 0.408, which was evaluated as having no significant difference, and other experimental groups were evaluated that there was a significant difference. As a result of analyzing the test performed by changing the ROI position and scan delay time of control and experimental groups A and B, setting the ROI at the circle of willis level and testing after 4-second delay as soon as contrast enhancement is made in MCA will be useful for Brain CTA test in hemorrhagic stroke patients.
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박정환(Jeong-Hwan Park),이현성(Hyeon-Seong Lee),이은서(Eun-Seo Lee),한효정(Hyo-Jeong Han),허윤희(Yun-Hee Heo),최재호(Jae-Ho Choi) 대한방사선과학회(구 대한방사선기술학회) 2023 방사선기술과학 Vol.46 No.6
This study was intended to evaluate the shielding rate of radiation shields manufactured using 3D printers that have recently been used in various fields by comparing them with existing shields made of lead, and to find out their applicability through experiments. A 3D printer shield made of tungsten filament 1 mm, 2 mm, 4 mm shield, RNS-TX (nanotungsten) 1.1 mm, lead 0.2 mmPb, and 1mmPb were exposed to 99mTc, 18F, and 201TI for 15, 30, 45 minutes, and 60 minutes after measuring cumulative dose three times. Based on this, the shielding rate of each shield was calculated based on the dose in the absence of the shield. In addition, 99mTc, 18F, and 201TI were located 100 cm away from the phantom in which the OSLD nano Dot device was inserted, and if there was no shield for 60 minutes, the dose of thyroid was measured using 1.0 mm of lead shield, 1.1 mm of RNS-TX shield, and 2 mm of tungsten shield made by 3D printer. The use of shields during radiation shielding emitted from open radiation sources all resulted in a reduction in dose. The radiation dose emitted from the radionuclides under the experiment was all reduced when the shield was used. This study has been confirmed that tungsten is a material that can replace lead due to its excellent performance and efficiency as shield, and that it even shows the possibility of manufacturing a customized shield using 3D printer.
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