- 期刊
評估數位斷層合成攝影術對X光透視導引的輔助－以經皮胃管置入術為例
Evaluations the Assistance of Digital Tomosynthesis for Fluoroscopy Guided-Example of Percutaneous-Gastrostomy Tube Insertion
摘要
數位斷層合成攝影術以平板偵檢器數位式X光機使用與斷層攝影相同的成對原理，在一次X光曝露下，重組出X光曝射範圍內連續切層的斷層影像序列。本研究目的在評估利用數位斷層合成影像進行定位輔助，藉ACR認證假體，驗證X光管球擺動角度與相對應切層厚度的的關係，再計算不同運算法的重組時間，並對不同重組類型的影像輔助效果進行評比。使用40度X光管球擺動角度所獲得的斷層合成影像切層厚度為2mm；而使用濾波逆投射法重組41張影像比位移與累加法重組快約27秒；利用Wilcoxon signed-rank test評估分析，醫師對於藉由層析影像進行判定組織與器械相對位置的難易度，P值等於0.0016，顯示相對於二維透視影像，使用斷層合成攝影影像，更容易獲得治療部位內器械與組織的相對位置關係。因此，在進行X光透視導引定位的檢查或治療時－如經皮胃管置入術，利用斷層合成的序列影像，更能提供關於器官或組織與手術器械相對位置的影像空間資訊，使定位確認更精確，進而縮短手術時間。
並列摘要
Tomosynthesis technique in flat panel digital X-ray system uses similar ”twinning principle” theory to tomography to produce serial sectional images under single X-ray exposure. This study uses the tomosynthesis technique and the ACR CT accreditation phantom to verify the relationship of the swing angle of X-ray tube and sectional thickness. In addition, the reconstruction time and the assistance of tomosynthesis for different algorithm also evaluated. At 40 degrees swing angle of X-ray tube, the sectional thickness of each tomosynthesis image was 2 mm. The reconstruction time for 41 images using filtered back projection was 27 seconds faster than shift and add algorithm. In test of fluoroscopy versus tomosynthesis in identifying the relative location between instrument and specific tissue, the result of Wilcoxon signed-rank test showed a p-value of 0.0016. This implies that using tomosynthesis images in localization of instrument in diagnosis and/or treatment was superior to using 2D fluoroscopy images. Therefore, during the fluoroscopy guided diagnosis or treatment, this technique provides additional spatial information to improve the accuracy of localization. Using these tomosynthesis images the radiologist has more accurate spatial information during fluoroscopy guided procedures, such as percutaneous-gastrostomy tube insertion, and may shorten the operative time.
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