跳到主要內容

臺灣博碩士論文加值系統

(44.200.169.3) 您好!臺灣時間:2022/12/01 01:07
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

我願授權國圖
: 
twitterline
研究生:陳美真
研究生(外文):Mei-Jen Chen
論文名稱:64層切面電腻斷層冠狀動脈血管攝影之臨床輻射劑量評估
論文名稱(外文):Assess of the Clinical Radiation Dose of 64-MSCT Coronary Angiography
指導教授:林招膨林招膨引用關係
指導教授(外文):Jao-Perng Lin
學位類別:碩士
校院名稱:元培科技大學
系所名稱:放射技術研究所
學門:醫藥衛生學門
學類:醫學技術及檢驗學類
論文種類:學術論文
論文出版年:2010
畢業學年度:98
語文別:中文
論文頁數:76
中文關鍵詞:多層切面電腻斷層掃描電腻斷層心臟冠狀動脈血管攝影冠狀動脈心臟病全身有效劑量
外文關鍵詞:Multi-slice Computer TomographyCT coronary angiographycoronary heart diseasewhole body effective dose
相關次數:
  • 被引用被引用:1
  • 點閱點閱:247
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:1
本文目的於評估電腻斷層心臟冠狀動脈血管攝影之輻射劑量,以TOSHIBA Aquilion 64層切面電腻斷層掃描儀、侖道擬人形假體(RANDO Phantom)及熱發光劑量計TLD-100H型,依實際檢查程序執行掃描,探討使用及不使用心電圖閘門(ECG gating)功能之輻射劑量。假體因無法模擬真人心搏生理現象,所得數據頇乘上修正因子(gating/non-gating之比值)0.416,以求得使用心電圖閘門掃描之劑量。
ICRP未將心臟歸列危急器官,詴以ICRP 60及ICRP 103號報告建議之0.025及0.060作為心臟之加權因數。結果未使用心電圖閘門者,以ICRP-60之標準評估,不含心臟之全身有效劑量為17.352 mSv,約等於接受867.62次胸腔x光攝影(0.02 mSv/次),含心臟為18.203 mSv,約等於接受910.20次,增幅0.852 mSv約為42.58次。以ICRP-103之標準評估,未含心臟為18.161 mSv,約等於接受908.06次胸腔x光攝影,含心臟為20.205 mSv,約等於接受1010.26次,增幅2.044 mSv約為102.20次。使用心電圖閘門,以ICRP-60之標準評估,未含心臟之全身有效劑量為7.219 mSv,約等於接受360.93次胸腔x光攝影,含心臟增為7.573 mSv,約等於接受378.64次,增幅0.354 mSv約為17.71次。以ICRP-103之標準評估,未含心臟為7.555 mSv,約等於接受377.75次胸腔x光攝影,含心臟為8.405 mSv,約等於接受420.27次,增幅0.786 mSv約為42.52次。
This study aimed to evaluate radiation dose of CT coronary angiography. Equipments used include TOSHIBA Aquilion 64 slice computed tomography; RANDO humanoid phantom and thermoluminescent dosimeter TLD-100H. Radiation does with and without ECG gating were obtained. To obtain the dose for cardiac gating the data is actually multiplied by correction factor (gating / non-gating ratio) 0.416 because the RANDO phantom cannot mimic human cardiac physiological phenomenon.
ICRP does not take the heart as the critical organ. This study attempted to use the ICRP 60 report, with a proposed value 0.025 and the ICRP 103 report, a proposed value is 0.06, as the heart weighting factors. Under ICRP-60 criteria, the whole body effective dose excluding heart and including the heart without cardiac gating is 17.352 mSv, (equivalent of 867.62 chest x-rays) and 18.203 mSv (equivalent of 910.20 chest x-rays) respectively; an increase of 0.852 mSv (equivalent of 42.58 chest x-rays). Results without using the cardiac gating, under ICRP-130 criteria, the whole body effective dose excluding heart and including the heart is 18.161 mSv, (equivalent of 908.06 times chest x-rays) and 20.205 mSv (equiavalent of 1010.26 times chest x-rays) respectively; an increase of 2.044 mSv (equivalent of 102.20 times chest x-rays).
Under ICRP-60 criteria, the whole body effective dose excluding heart and including the heart with ECG gating is 7.219 mSv (equivalent of 360.93 chest x-rays) and 7.573 mSv (equivalent of 378.64 chest x-rays) respectively; an increase of 0.354 mSv (equivalent of 17.71 times chest X-rays). Results with using the cardiac gating, under ICRP-130 criteria, the whole body effective dose excluding heart and including the heart is 7.555 mSv (equivalent of 377.75 chest x-rays) and 8.405 mSv (equivalent of 420.27 chest x-rays) respectively; an increase of 0.786 mSv (equivalent of 42.52 chest x-rays).
摘要 …………………………………………………………………I
英文摘要 ……………………………………………………………II
致謝 …………………………………………………………………IV
目錄 …………………………………………………………………V
表目錄 ………………………………………………………………VII
圖目錄 ………………………………………………………………IX
第一章
緒論 ………………………………………………………1-13
1.1 前言 ………………………………………………………1
1.2 國內冠狀動脈心臟病概況 ………………………………2
1.3 研究背景及目的 …………………………………………6
1.4 輻射防護概念 ……………………………………………7
1.5 文獻探討 …………………………………………………10
1.6 實驗架構 …………………………………………………13
第二章
實驗儀器與設備 …………………………………………14-32
2.1 電腻斷層掃描儀 …………………………………………14
2.1.1 電腻斷層掃描儀結構及特性 …………………………15
2.1.2 冠狀動脈電腻斷層血管攝影條件 ……………………23
2.2 熱發光劑量計 ……………………………………………24
2.2.1 熱光劑量計簡介 ………………………………………24
2.2.2 熱發光劑量計發光原理 ………………………………25
2.3 計讀儀 ……………………………………………………29
2.4 侖道擬人形假體 …………………………………………31
第三章
研究步驟與方法 ……………………………………………33-45
3.1 熱發光劑量計TLD-1000之處理與使用 ………………33
3.1.1 TLD-100H之迴火程序…………………………………33
3.1.2 TLD-100H之篩選及校正………………………………34
3.2 熱發光劑量計TLD-100H佈點範圍選定及MSCT掃描……36
3.3 輻射劑量之評估方式………………………………………45
第四章
臨床劑量評估與劑量探討 …………………………………49-71
4.1 臨床假體劑量評估 ………………………………………49
4.2 輻射風險評估 ……………………………………………56
4.3 劑量探討 …………………………………………………62
第五章
結論 ………………………………………………………72-73
第六章
參考文獻 …………………………………………………74-76
1. Kopp AF, et al. Multislice Computed Tomography: Basic Principles and Clinical Applications. Electromedica 2000; 68 (2) : 94-105.
2. Hu H, et al. Four Multidetector-Row Helical CT: Image Quality and Volume Coverage Speed. Radiology 2000; 215: 55–62.
3. Kohl G. The Evolution and State-of-the-Art Principles of Multislice Computed Tomography. Proc Am Thorac Soc 2005; Vol. 2: pp 470–476.
4. Goldman LW. Principles of CT: Multislice CT. Journal of Nuclear Medicine Technology 2008; 36(2): 57-68.
5. ICRP 1990 recommendations of the international commission on radiological protection. ICRP Publication 60. Oxford: Pergamon Press 1991; 2-43.
6. ICRP, ― 2007 Recommendations of the International Commission on Radiological Protection,‖ International Commission on Radiological Protection, Oxford: Pergamon Press, Publication 103,2007.
7. J. Gofman. X Rays, Cancer and Heart Disease. Magazine article by Albert L. Huebner; World and I, Vol. 15, April 2000.
8. United Nations Scientific Committee on the Effects of Atomic Radiation, UNSCEAR 2000 Report to the General Assembly, with Scientific Annexes, Volume I: Sources New York, 2000.
9. Mettler FA, Wiest PW, Locken JA, Kelsey GA. CT scanning: Patterns of use and dose. J. Radiol. Prot 2000; 20: 353-359.
10. Shrimpton PC, Edyvean S. CT scanner dosimetry. Br. J. Radiol 1998; 71: 1-3.
11. 行政院原子能委員會。游離輻射防護安全標準。台北市。中華民國九十四年。
12. 張泉,田野。醫療照射致癌危險分析。國外醫學臨床放射學分冊。2005; 28(3): 191-3。
13. 蔡惠予。電腻斷層的輻射劑量研究。博士論文,清華大學,新竹。中華民國九十一年。
14. Brenner DJ, Elliston CD. Estimated Radiation Risks Potentially Associated with Full-Body CT Screening. Radiology 2004; 232: 735-738.
75
15. Brenner DJ, Hall EJ. Computed Tomography — An Increasing Source of Radiation Exposure. N EJM 2007; 357: 2277-84.
16. Alkadhi H. Radiation dose of cardiac CT—what is the evidence? Eur Radiol 2009; 19: 1311–1315.
17. Halliburton SS. Options for reducing patient radiation dose with cardiovascular computed tomography. Int J Cardiovasc Imaging 2009; 25(2): 153-164.
18. Redberg RF. Cancer Risks and Radiation Exposure From Computed Tomographic Scans. ARCH INTERN MED 2009; 169(22): 2049-2050.
19. Gerber TC, Carr JJ, Arai AE. Ionizing Radiation in Cardiac Imaging: A Science Advisory From the American Heart Association Committee on Cardiac Imaging of the Council on Clinical Cardiology and Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention. Circulation 2009; 119: 1056-1965.
20. Picano E. The Risks of Inappropriateness in Cardiac Imaging. Int. J. Environ. Res. Public Health 2009; 6: 1649-1664.
21. Berrington GA, Mahesh M, Kim KP, et al. Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Intern Med 2009; 169(22): 2071-2077.
22. Smith BR, Lipson J, Marcus R, et al. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med 2009; 169(22): 2078-2086.
23. 許彬杰、翁寶山編著。實用固體熱發光劑量測定數。一版。台北,合計圖書出版社。中華民國九十一年六月。第 21-41頁。
24. 朱鐵吉。放射物理學及輻射劑量學導論。一版。台北,合計圖書出版社。中華民國九十八年九月。第395-411頁。
25. Chen CC, Chiu JH, Chan HM. Investigation of Energy and Angular Dependence for LiF: Mg, Cu, P Thermoluminescent Detectors. Taiwanese Journal of Applied Radiation and Isotopes 2009; 5(2): 637-644.
76
26. Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating Risk of Cancer Associated With Radiation Exposure From 64-Slice Computed Tomography Coronary Angiography. JAMA 2007; 298: 317-323.
27. Kim KP, et al. Coronary artery calcification screening. Estimated radiation dose and cancer risk. Arch Intern Med 2009; 169(13): 1188-94.
28. Gibbons RJ, Gerber TC. Calcium Scoring With Computed Tomography What Is the Radiation Risk? ARCH INTERN MED 2009; 169 (13): 1185-7.
29. Safety: Radiation Exposure in X-ray Examinations. RSNA 2009; 1-4.
30. VEINOT JP, EDWARDS WD. Pathology of Radiation-lnduced Heart Disease: A Surgical and Autopsy Study of 27 Cases. HUMAN PATHOLOGY 1996; 27(8): 766-773.
31. Morin RL, Gerber TC, McCollough CH. Radiation Dose in Computed Tomography of the Heart. Circulation 2003; 107: 917-922.
32. Brenner DJ, et al. Cancer risks attributable to low doses of ionizingradiation: Assessing what we really know. PNAS 2003; 100(24): 13761–13766.
33. Hall EJ, Brenner DJ. Cancer risks from diagnostic radiology. Br. J. Radiol 2008; 81(965): 362-378.
34. 陳惠萍。人類纖維母細胞株受低劑量輻射照射後基因表現之分析。碩士論文,中臺科技大學,台中。中華民國九十六年七月,第30-58頁。
35. Drs. Pizzzarello, Witcofski. Medical Radiation Biology.1982: 43.
36. Lee CI, Haims AH, Monico EP, Brink JA, Forman HP. Diagnostic CT scans: assessment of patient, physician, and radiologist awareness of radiation dose and possible risks. Radiology 2004; 231: 393-8.
電子全文 電子全文(本篇電子全文限研究生所屬學校校內系統及IP範圍內開放)
連結至畢業學校之論文網頁點我開啟連結
註: 此連結為研究生畢業學校所提供,不一定有電子全文可供下載,若連結有誤,請點選上方之〝勘誤回報〞功能,我們會盡快修正,謝謝!
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top