Presentation of anatomical structures when imaging the lumbar spine lateral

Uvod: Pri prikazu anatomskih struktur ledvene hrbtenice je najpreprostejša in najbolj dostopna diagnostična metoda rentgensko slikanje. Njen namen je prikazati bolezenske procese ter poškodbe hrbtenice. Standardni radiografski pregled za oceno ledvenega dela hrbtenice vključuje anteroposteriorno in stransko projekcijo, zaradi diagnostičnih potreb pa se lahko izvede slikanje hrbtenice tudi pod različnimi koti. Namen: Namen diplomskega dela je prikazati anatomske strukture ledvene hrbtenice pri rentgenskem slikanju ob spreminjanju položaja hrbtenice ter različnih projekcijah pod kotom od 0° do 30° v anteriorni in posteriorni smeri. Pri tem želimo oceniti prikazane anatomske strukture po kriteriju za kakovost rentgenograma. Metode dela: Meritve smo izvedli v dveh delih. Prvi del je sestavljala deskriptivna metoda, ki je vključevala pregled domače in tuje strokovne literature, pridobljene na spletu ter v Knjižnici Velenje in knjižnici Zdravstvene fakultete Univerze v Ljubljani. Druga metoda je bila raziskovalno delo, kjer smo s pomočjo fantoma primerjali prikaze anatomskih struktur ledvene hrbtenice, ko je le-ta pod različnimi koti. Za podlaganje smo uporabili stiropor, kjer je 1 cm predstavljal ravno 5° kota. Rezultati: Z raziskavo na fantomu smo ugotovili, da se anatomske strukture ledvene hrbtenice pod različnimi koti obračanja spreminjajo, povečujejo. Pri večjih kotih pride tudi do prekrivanj in težjega ločevanja struktur. V celoti smo ugotovili, da se pri posteriornem podlaganju fantoma telo tretjega ledvenega vretenca v povprečju poveča za 0,7 cm, širina stranskega odrastka se v povprečju zmanjša za 1,11 cm. Pri anteriornem podlaganju fantoma se telo tretjega ledvenega vretenca v povprečju poveča za 0,34 cm in stranski odrastek postane zaradi prekrivanja struktur težji za razlikovanje od ostalih struktur. To nastane zaradi odmaknjenosti in neustrezne poravnave objekta s slikovnem sprejemnikom. Razprava in zaključek: Z večanjem kota se pričnejo anatomske strukture projicirati ena na drugo in onemogočajo razlikovanje med posameznimi anatomskimi strukturami. Pri rentgenogramih ledvene hrbtenice je pomembna natančnost pri nastavljanju pacientov, saj s tem pridobimo enojne anatomske strukture in diagnostično uporabne rentgenograme. V praksi se standardno uporabljata anteroposteriorna in stranska projekcija ledvene hrbtenice. Vse ostale projekcije so nekoristne, saj povečajo dozno obremenitev pacienta. Uporabljamo jih zgolj v primeru, kadar so za to navedene potrebe za postavitev pravilne diagnoze.Introduction: In showing the anatomical structures of the lumbar spine, the simplest and most accessible diagnostic method is X-ray imaging. Its purpose is to show the disease processes and spinal injuries. The standard radiographic examination for evaluating the lumbar spine includes anteroposterior and lateral projection. Due to diagnostic needs, spine imaging can also be performed at different angles. Purpose: The purpose of this thesis is to show the anatomical structures of the lumbar spine in X-ray imaging by changing the position of the spine and in various projections at an angle from 0 ° to 30 ° in the anterior and posterior directions and in doing so, evaluate the presented anatomical structures according to the criteria for the quality of the radiograph. Methods: The measurements were performed in two parts. The first part consisted of a descriptive method, which included a review of domestic and foreign professional literature obtained online and in the library of Velenje and the library of the Faculty of Health Sciences, University of Ljubljana. The second method was research work, where we used a phantom to compare the representations of the anatomical structures of the lumbar spine at different angles. Polystyrene was used for the lining, where 1 cm represented exactly 5 ° of the angle. Results: Through research on the phantom we found out, that the anatomical structures of the lumbar spine at different angles of rotation change, they increase. At larger angles, overlaps and more difficult separation of structures also occur. In overall, we found out that in the posterior lining of the phantom, the body of the third lumbar vertebra increased by an average of 0.7 cm, and the width of the transverse process decreased by an average of 1.11 cm. While in the anterior lining of the phantom, the body of the third lumbar vertebra increases by an average of 0.34 cm and the transverse process becomes more difficult to distinguish from other structures due to the overlap of the structures. All this occurs because of the remoteness and inadequate alignment of the object and the image receiver. Discussion and conclusion: As the angle increases, the anatomical structures begin to project one onto another and make it impossible to distinguish between individual anatomical structures. In lumbar spine radiographs, accuracy in setting patients is important, as this results in uniform anatomical structures and diagnostically useful radiographs. In practice, anteroposterior and lateral projection of the lumbar spine are used as standard. All other projections are useless as they increase the dose load of the patient, they are used only when the need for a correct diagnosis is stated