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研究生:黃定宇
研究生(外文):Huang Ding-Yu
論文名稱:比較64切與256切心臟冠狀動脈電腦斷層掃描造成病人之有效劑量
論文名稱(外文):Comparison of Effective Doses on undergoing Cardiac Coronary Angiography between 64- and 256-Multislice CT Scanners
指導教授:邱志宏邱志宏引用關係
指導教授(外文):Chiu Jih-Hung
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
畢業學年度:99
語文別:中文
論文頁數:55
中文關鍵詞:64切片電腦斷層256切片電腦斷層心臟冠狀動脈電腦斷層有效劑量熱發光劑量計
外文關鍵詞:64–MSCT256–MSCTComputed Tomography Coronary AngiographyEffective doesthermoluminescent dosimeter (TLD)
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隨著多切片電腦斷層(MSCT)的發展,心臟冠狀動脈電腦斷層(computer tomography coronary angiography, CTCA)檢查技術趨近於成熟,由於有著非侵入性的優點,因此有越來越多人接受此項檢查,然而對於所接受到的輻射劑量以及降低劑量的方法也越來越受到人們的關注。本研究是利用侖道假體(Rando phantom)來比較64切與256切(64-MSCT與256-MSCT)心臟冠狀動脈電腦斷層掃描造成病人有效劑量之研究。將晶片型(0.89 mm厚)熱發光劑量計GR-200 (LiF:Mg,Cu,P) 依人體器官位置放置於侖道假體切面內預留之小孔內,以測量ICRP-60號報告所定義之人體主要輻射敏感器官之吸收劑量,且將薄膜型(0.1 mm厚)熱發光劑量計TLD (GR-200F)貼置於假體表面的心臟切面位置之前方、左右兩側與後方,以測量皮膚表面劑量。各CT使用兩種掃描條件進行CTCA掃描檢查,第一種掃描條件使用目前醫院臨床的心臟冠狀動脈掃描參數,每次度量時,以此參數重複掃描侖道假體五次,然後將各TLD測讀值除以5求取平均值做為一次掃描檢查之吸收劑量。得到假體內與表面之吸收劑量與分佈後,各器官吸收劑量乘上ICRP-60號報告所提供的組織加權因數(WT),總和之得到64-MSCT與256-MSCT各別造成之有效劑量。第二種掃描條件則是將64-與256-MSCT設定相近掃描參數即依機器之特性將有效mAs/pitch全部調成600 mAs,以此條件同樣重複掃描侖道假體五次,求取每次實際檢查之各器官劑量平均值,同樣依ICRP-60號報告計算兩種MSCT機器造成的有效劑量。
實驗結果顯示,臨床例行檢查冠狀動脈電腦斷層造成之有效劑量,64-及256-MSCT 掃描儀分別為26.89 mSv及24.83 mSv。256-MSCT約比64-MSCT低8%。當有效管電流調降為600 mAs時,64-及256-MSCTs有效劑量分別為21.58 mSv及19.76 mSv。64-及256-MSCT調降有效管電流為600 mAs時,均可比常規所使用的條件減少約20% 的有效劑量,因此,依照受檢者的體型來選擇適當的劑量參數亦可減少受檢者所接受到的輻射劑量。未來,多切片電腦斷層將會不斷的朝向減低病人劑量,並且得到更好的影像品質發展。

With the ongoing development of multi-slice computer tomography (MSCT), the techniques of computer tomography coronary angiography (CTCA) are approaching maturity. Because of the advantage of being non-invasive, there are increasing patients who undergo with this investigation. However, as there is concern of radiation dosage that the patients receive, means to reduce radiation dosage are becoming more important.
Our study aim is to compare the effective doses on patients undergoing computed tomography coronary angiography (CTCA) using 64- and 256-Multislice CT scanners on phantom test. Using a Rando anthropomorphic phantom, we placed thermoluminescent dosimeters (TLD) into the center, anterior, and lateral aspect of the lower chest of the phantom. Standard coronary angiography was performed with the current clinical protocols used in our institution on the 64-, and 256-MSCTs on the Philip systems. Next, we use near-identical protocols on both the 64- and 256-MSCT to perform coronary angiography to compare the effective radiation dosage.
The results showed that the effective dose in the clinical routine scan of computer tomography coronary angiography in the 64- and 256-MSCT scanners were 26.89 mSv and 24.83 mSv, respectively. About 8% reduction in the effective radiation dosage was measured in 256-MSCT compared with 64-MSCT. When the effective mAs were reduced to 600mAs, the effective dosage of 64 - and 256-MSCTs were 21.58 mSv 19.76 mSv, respectively. Therefore, there is about 20% reduction in the effective radiation dosage we reduce the effective mAs to 600mAs compared with the clinically used protocols. As the MSCT technology continue to advance, the patients benefit with more detailed examinations. However, how we reduce the associated radiation dosage should be our continued goal for the future.

致謝
摘要
Abstract
目錄
圖目錄
表目錄
第一章 緒論
1.1研究動機
1.2 研究背景與目的
1.3 文獻回顧
第二章 基礎理論
2.1 冠狀動脈生理與解剖概論
2.2 冠狀動脈心臟病發生原因
2.3 實驗室的檢查
2.4 治療方式
2.5電腦斷層 (Computed Tomography, CT)
2.6 電腦斷層劑量指標(CTDI)
2.7 熱發光原理
2.8 輻射劑量之定義
2.9 有效劑量之評估
第三章 實驗材料與方法
3.1電腦斷層儀(CT)
3.2 侖道假體 (Rando phantom)基本資料
3.3 熱發光劑量計
3.4 熱發光劑量計計讀儀
3.5 TLD迴火設備
3.6 TLD劑量校正流程
3.7 研究方法與實驗設計
3.8 TLD佈點
第四章 實驗結果與討論
4.1 熱發光劑量篩選與校正結果
4.2 劑量評估
第五章 結論與未來展望
5.1 結論
5.2 未來展望
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