Title Uloga digitalne subtrakcijske angiografije u kliničkoj praksi
Title (english) THE ROLE OF DIGITAL SUBTRACTION ANGIOGRAPHY IN CLINICAL PRACTICE
Author Ana Miličević
Mentor Krešimir Dolić (mentor)
Committee member Tade Tadić (predsjednik povjerenstva)
Committee member Sanja Lovrić Kojundžić (član povjerenstva)
Committee member Krešimir Dolić (član povjerenstva)
Granter University of Split (University Department of Health Studies) Split
Defense date and country 2016-07-14, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences
Abstract Nakon što je 1980. godine predstavljen prototip komercijalnog DSA uređaja, ova tehnologija je uvedena i počela se sve više primjenjivati u kliničkoj praksi uz neprestani razvoj i usavršavanje tehničkih mogućnosti iste. DSA danas predstavlja zlatni standard za prikaz krvnih žila. Glavni dijelovi aparata su generator i rendgenska cijev te detektori. Generatori daju snagu 80-100 kW i imaju mogućnost pulsne dijaskopije. Stoga, rendgenske cijevi moraju biti konstrukcijski prilagođene pa je anoda građena od materijala velikog toplinskog kapaciteta. Velikom brzinom rotacije i žarištem u obliku prstena smanjuje se njezino pregrijavanje. Ima tri fokusa, a najmanji se koristi pri dijaskopiji. Najnovije generacije uređaja za DSA kao receptor slike koriste ravni detektor koji ima visok konverzijski faktor, a glavna mu je prednost što je smanjena doza zračenja za pacijenta te su dobivene slike visoke kvalitete. Uređaj je konstruiran u obliku C-luka, a najčešće se koristi monoplane DSA aparat. Glavni princip nastanka slike je subtrakcija, odnosno oduzimanje nativne snimke ili maske od snimke s kontrastnim sredstvom kako bi na angiogramu dobili prikaz samo krvnih žila bez okolnog tkiva i kosti. Kod izvođenja angiografija koriste se jodna kontrastna sredstva koja se najčešće apliciraju automatskim injektorom pod određenim tlakom i brzinom. Slike u digitalnom obliku moguće je na računalu naknadno obrađivati. Mjerenje udaljenosti, Windowing, Peristeping, Roadmap samo su neke od programa postprocessinga. Osim subtrakcije uređaj ima mogućnost 3D-DSA i 3D-FDSA, a sve slike mogu biti prikazane kao subtrahirane i kao nativne. 3D-FDSA je jedna od najnovijih tehnika koja predstavlja fuziju 3D slike kosti i 3D slike krvnih žila. Najčešće indikacije za angiografski pregled su ateroskleroza krvnih žila, tumori, aneurizme, krvarenja itd. Pri svakom intervencijskom postupku osoblje i pacijent su izloženi određenoj dozi zračenja. Stoga je obvezno pridržavanje svih mjera zaštite od zračenja. Prvostupnik radiološke tehnologije obvezan je suziti širinu primarnog rendgenskog snopa, smanjiti dozu zračenja na minimum pridržavajući se ALARA principa, mora znati koristiti standardne protokole za određene pretrage, rukovati automatskim injektorom i poznavati rad na računalu. Cijeli tim obavezan je nositi osobna zaštitna sredstva i dozimetar.
Abstract (english) After the prototype of commercial DSA device has been presented in 1980 this technology started to use in clinical practice with the continuous development and improvement of the technical capabilities of the same. DSA has been considered as a gold standard for blood vessel imaging. The main parts of device are generator, X-ray tube and detector. Generator gives 80-100 kW power and they have ability of pulsed fluoroscopy. Construction of X-ray tube must be adapted. Therefore, anode is built of high-heat capacity material. The heating of the anode is reduced because of its fast rotation and focus ring shape. It has got three focuses and the smallest one is used in fluoroscopy. The latest generation of devices for DSA as image receptor using Flat panel X-ray detector which has high DQE, and its main advantage is the reduced radiation dose for the patient and high quality images. The device is constructed in the form of C arm; commonly used monoplane DSA machine. The main principle of image creation is subtraction of the native images or mask images from the contrast images in order to get the angiogram to see only blood vessels without surrounding tissue. When performing angiography iodine contrast medias are usually used and are applied by automatic injector under certain pressure and speed. Images in digital form on a computer may be later processed. Distance measurement, Windowing, Peristepping, Roadmpping are just some of the programs of postprocessing. Except subtraction device can do 3D-DSA and 3D-FDSA and all images can be displayed as substracted or native images. 3D-FDSA is one of the newest techniques that present the fusion of 3D bone images and 3D blood vessels images. The most common indication for angiography examination is atherosclerosis, tumors, aneurysm, bleeding etc. In any interventional procedures both stuff and patients are exposed to a certain dose of radiation. Therefore is required adherence to all measures od of radiation protection. Bachelor radiological technology is obliged to narrow the widh of primary x-ray beam, reduce the dose of radiation to a minimum following the ALARA principle, should be able to use standard protocols for some examinations, to handle an automatic injector and to know to work on the computer. The whole team is obliged to wear personal protective equipment and dosimeter.
Keywords
DSA uređaj
prikaz krvnih žila
subtrakcija
Keywords (english)
DSA device
blood vessel imaging
subtraction
Language croatian
URN:NBN urn:nbn:hr:176:727621
Study programme Title: Radiologic Technology (university/undergraduate) Study programme type: university Study level: undergraduate Academic / professional title: sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) radiološke tehnologije (sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) radiološke tehnologije)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2020-06-03 09:05:51