Arts and Evaluation of whole-spine radiography with respect to gonadal shielding in female patients with idiopathic scoliosis 1 59858 2 25483 1 48473 1 52805 3 37576 2 19263 1 2 3 Key words: Whole-spine radiation, Gonad shielding, Idiopathic scoliosis Summary Whole-spine radiography is employed periodically for patients with idiopathic scoliosis. Young female patients who are susceptible to radiation account for most cases of idiopathic scoliosis. In our clinic, gonadal shielding is therefore required for all female patients aged younger than 50. However, because of the poor reproducibility of protector placement and disagreement between the shapes of the protector and the pelvic cavity, adequate gonadal shielding is not achieved. In this study, we report on the development and evaluation of an examination gown for whole-spine radiography that enables adequate gonadal shielding in female patients with idiopathic scoliosis. The results suggested that installation of protectors of the same size regardless of the body type or height 8.5cm below Jacoby s line allowed highly reproducible and adequate gonadal shielding. 50 8.5cm 1 1 2 3 12 Cobb 1 3 7 70 80% 85% Eri Hayashi 1 59858, Kyoichi Kato 2 25483, Hironobu Fujisawa 1 48473, Ayako Shibuya 1 52805, Toshiyuki Takahashi 3 37576, Yasuo Nakazawa 2 19263 1 Showa University Fujigaoka Hospital Department of radiology 2 Showa University Graduate School Health 3 Showa University Graduate School Health 3 4 8 9 11 50 1 1-1 23 1405
す影響の検討を行った 座高が骨盤腔に及ぼす影響を なお 本研究に用いた画像については 全て当院倫 全脊椎画像における頭頂 座骨下縁の距離と骨盤腔の 理委員会の使用許可 平成 27 年 05 月 19 日承認番号 短径を計測 Fig.1 することで また体形が骨盤腔 2015011 を得ている に及ぼす影響を骨盤と骨盤腔の長径を計測 Fig.2 することで それぞれの関連性について検討し 特 1-2 プロテクター最適装着位置の決定方法 発性側彎症患者専用のプロテクターを作成した 計 プロテクターの装着位置を決定する基準線を 立位 測には 平成 25 年 4 月から平成 26 年 3 月までに当院 でも触知しやすいヤコビー線とし 症例ごとに座高と で撮影した全脊椎撮影において 無作為に抽出した ヤコビー線 骨盤腔上縁間距離を計測 Fig.3 し 50 歳未満女性 47 人の全脊椎正面撮影画像を用いた その関連性を検討することで ヤコビー線をプロテク a b Fig.1 Sitting height-minor axis of the pelvic cavity measure method a Sitting height A Vertex B Inferior margin of the ischium b Minor axis of the pelvic cavity C Superior margin of the pelvic cavity D Superior margin of the pubic symphysis Fig.2 Major axis of the pelvis Major axis of the pelvic cavity measure method E Major axis of the pelvis F Major axis of the pelvic cavity 24 1406 日本診療放射線技師会誌 2016. vol.63 no.769 Fig.3 Distance between Jacoby s line and superior margin of the pelvic cavity measure method G Jacoby s line C Superior margin of the pelvic cavity
Arts and 1-1 47 1mm 150g Fig.7 1-3 1-11-2 2-2 7.8cm 0.7 Fig.8 7cm 8.5cm 1-4 Y X Y X 2 2-1 Fig.4 Fig.5 Fig.6 94cm70cm5.3 1.3 Fig.4 2.0 1.3 Fig.5 16.0cm 12cm Fig.5 Major axis of the pelvis major axis of the pelvic cavity Sitting height Ave:86.3 SD:5.3 Major axis of the pelvis Ave:26.7 SD:2.0 Fig.6 Correlation diagram Minor axis of the pelvic cavity Ave:9.4 SD:1.3 Major axis of the pelvic cavity Ave:13.0 SD:1.3 Fig.4 Sitting height minor axis of the pelvis cavity Fig.7 Protector for whole-spine radiography 25 1407
Fig.8 Distance between Jacoby s line and superior margin of the pelvic cavity Fig.10 Examination gown for whole-spine radiography Fig.9 Distance between Jacoby s line and superior margin of the pelvic cavity number of cases according to the distance Fig.11 Comparison between conventional and new radiographic methods with respect to the vertical gap and the horizontal gap distance of protectors Fig.9 2-3 8.5cm Fig.10 2-4 11cm 3.6cm 2.8 2.5cm 1.1cm1.1 Fig.11 Mann-whitney U P<0.05 1.0cm0.8 0.5cm 0.6 Fig.11 1-4 3 3-1 26 1408 2016. vol.63 no.769
Arts and 3-2 3-3 7.8cm 8.5cm8cm 0.7 8.5cm 3-4 3.6cm 1.1cm 2.8 1.1 4 Fig.1 Fig.2 Fig.3 Fig.4 Fig.5 Fig.6 Fig.7 Fig.8 Fig.9 Fig.10 Fig.11 1! 1 37-40 2009 2 3 149 2014 3 10 466-468 2008 4 Rothman-Simeone The Spine 5 1 515-5242009 5 X1 122-123 PILAR PRESS 2013 6 6 1501-15 2010 7 X 2 218 2009 8 G 1 43 2014 9 3 99 2013 10! 1 37-40 2015 11 Q&A50 1 71-73 2012 27 1409