應用田口方法評量肋下像造影之最佳調整參數

目前介入性心導管檢查已是冠狀動脈疾病臨床診療的標準方法，而冠狀動脈攝影術中的肋下像（Subcostal view, Right Anterior Oblique-Caudal）是診斷左主冠狀動脈分岔處、左前降支開口與左迴旋支開口至中段最佳的影像，但常因某些因子改變而無法有效的將其血管分開導致血管重疊造成無法正確診斷出病灶。導致肋下像之影像在臨床診斷價值上大打折扣，進而影響治療方式。因此，本研究應用田口方法在模擬冠狀動脈假體中進行肋下像介入性心導管造影調整參數並選定最佳化調整組合，然後確認驗證，以驗證實驗的再現性。結果顯示，原設定的S/N比值為20.038dB、累積誤差為1.056%。而最佳化設定後S/N比值提升為20.585 dB、累積誤差為0.807%。最佳調整參數組合為使用攝影電壓濾片、右側位角度（RAO）50°、後側位角度（Caudal） 25°、攝影時的電壓70kV、脈波寬度調整8.0ms、攝影時管球與影像倍增管之距離（SID）：105cm。因為得到最佳參數組合優於原設定組別，故可將其結果應用於臨床上，有效提昇介入性治療時肋下像影像之品質。

關鍵字

冠狀動脈疾病（Coronary Artery Disease, CAD）；田口方法；肋下像（Subcostal view）

並列摘要

The optimization of coronary angiography of subcostal view via Taguchi methodology was studied in this work. Interventional cardiac catheterization of coronary artery disease was the standard method in clinical diagnosis and treatment. In doing so, the optimal diagnostic view of either left main trunk, left anterior descending artery or left circumflex artery ostium till to middle segment was recommended as the subcostal view. However, inappropriate parameter settings of the angiography often mislead the diagnosis in practical evaluation and cause the unnecessary treatment. Therefore, an indigenous cardiac phantom was adopted to imply a 90 kg adult patient and six parameters settings of X-ray facility was optimized to acquire the exposed cardiac imaging. The six factors were set as (A) with or without the X-ray filter; (B) angle of RAO; (C) angle of CAU; (D) kVp; (E) ms and (F) SID of X-ray. The optimized results implied the S/N and the cumulative error from the original 20.038 dB and 1.056% to revised 20.585 dB and 0.807%, respectively. Furthermore, the optimal setting of the X-ray facility was (A) with the X-ray filter; (B) 50o angle of RAO; (C) 250 angle of CAU; (D) 70 kVp; (E) 8.0 ms and (F) 105 cm of SID of X-ray. The follow up study also effectively confirmed the optimal setting of X-ray facility in practical verification.

並列關鍵字

Coronary artery disease ； Taguchi methodology ； Subcostal view

國際替代計量

應用田口方法評量肋下像造影之最佳調整參數

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