진폐요양기관의 흉부 디지털촬영과 아날로그촬영의 정도관리 비교
A Quality Assurance on Digital Chest Radiography in Medical Institution for Pneumoconiosis : Compared with Analog Radiography
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초록
분진에 노출되었던 자가 진폐소견을 갖고 있으면서 합병증이 발생하면 진폐요양기관에서 입원 치료를 받을 수 있다. 본 연구에서는 전국 33개 진폐요양기관의 실태조사 결과로부터 흉부 디지털촬영기관과 아날로그촬영기관의 정도관리를 비교 분석 하였다. 전체 진폐요양기관 중 24개 기관은 디지털촬영을 실시하고 있었고, 9개 기관은 아날로그촬영을 실시하고 있었다. 산업안전보건연구원 특수건강진단(진폐정도관리)기관 흉부 방사선분야 평가표를 이용하여 디지털촬영기관과 아날로그촬영기관 사이에 촬영기술 및 화질, 판독환경평가 결과를 비교하였고, 화질은 진폐판독정도관리 교육을 수료하고 진폐 판독경험이 많은 2명의 흉부 영상의학과전문의가 각각 독립적으로 평가한 후, 평균값을 사용하여 비교 하였다. 디지털촬영기관과 아날로그촬영기관 사이에 촬영장치 및 관전류, 조사시간에서는 유의한 차이를 보이지 않았지만, 관전압, 격자비에서는 유의한 차이를 보였다. 디지털촬영기관이 아날로그촬영기관보다 촬영기술과 판독환경에서 통계학적으로 유의하게 높았고, 화질에서도 높았지만 유의하지는 않았다. 따라서, 진폐요양기관이 아날로그촬영에서 디지털촬영으로 전환하게 되면 정도관리의 향상을 가져올 수 있다.
Abstract
Digital radiography has been replacing rapidly the analog radiography for diagnosis of pneumoconiosis. The purpose of this study is to compare quality control of digital radiography (DR) and analog radiog‐raphy (AR) for chest radiography in medical institution for pneumoconiosis (MIP)For the first time, we visited MIP to evaluate the chest radiography which is used for patients with pneu‐moconiosis, including equipment, technical parameters and reading environment. There were 33 institutions. DR and AR were installed in 24 and 9 institutions, respectively. Between DR and AR, we compared the ra‐diological technique (RT), image quality (IQ) and reading environment (RE) to use the guideline published by Occupational Safety and Health Research Institute (OSHRI). The image quality was rated by two experi‐enced chest radiologists for pneumoconiosis with certified from OSHRI. The chest radiography equipment was not significantly difference between AR and DR, but there were significantly difference in tube voltage and grid ratio used for chest radiography except to tube current, ex‐posure time. Statistically, DR is significantly higher in RT(70.3 vs. 43.8, p=0.009), RE(77.7 vs. 33.3, p=0.004) than AR, but it's not significantly difference in IQ (65.6 vs. 52.8, p=0.050). AR and DR in RT were passed 33.3%, 75.0% respectively (p=0.044) and 44.4%, 79.2% (p=0.090) in IQ and 44.4%, 91.7% (p=0.009) in RE. In MIP, DR needs to replace AR in diagnosis of pneumoconiosis.
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