18 Medical Imaging and Radiotherapy Journal (MIRTJ) 39 (Suppl. 1)
Medical Imaging and Radiotherapy Journal (MIRTJ) 39 (Suppl. 1)
UMIK MEHKEGA TKIVA PRI SLIKANJU MEDENICE STOJE: 
PRIMERJAVA DOZNE OBREMENITVE IN KAKOVOSTI 
RENTGENOGRAMA
FAT TISSUE DISPLACEMENT IN ERECT PELVIC RADIOGRAPHY: COMPARISON OF 
RADIATION DOSE AND IMAGE QUALITY 
Šejla Trožić 1,3, Andrew England 2, Nejc Mekiš 3
1 Univezitetni klinični center Ljubljana, Klinični inštitut za radiologijo, Zaloška cesta 7, 1000 Ljubljana, Slovenija / 
University medical centre Ljubljana, Institute of Radiology, Zaloška cesta 7, 1000 Ljubljana, Slovenia
2 University College Cork, Department of Radiography, Cork, Ireland
3 Univerza v Ljubljani, Zdravstvena fakulteta, Oddelek za radiološko tehnologijo, Zdravstvena pot 5, 1000 Ljubljana, Slovenija / 
University of Ljubljana, Faculty of health sciences, Medical Imaging and Radiotherapy Department, Zdravstvena pot 5, 
1000 Ljubljana, Slovenia
Korespondenca / Corresponding author: sejla.trozic1997@gmail.com
Prejeto/Recived: 14. 3. 2022
Sprejeto/Accepted: 22. 3. 2022
IZVLEČEK
Uvod in namen: V primerjavi s slikanjem medenice leže je 
pri slikanju medenice stoje višja doza in slabša kakovost 
rentgenograma. Namen raziskave je bil ugotoviti, ali se 
kakovost rentgenogramov in prejeta doza razlikujeta pri dveh 
različnih načinih slikanja medenice stoje – z odmikom in brez 
odmika mehkega tkiva. 
Metode dela: Prvi del je obsegal meritve na fantomu, kjer smo 
izbrali trak, ki ni povzročal vidnih artefaktov na rentgenogramu 
pri odmiku tkiva med preiskavo. Drugi del študije je bil izveden 
na 60 pacientih, ki so bili napoteni na rentgensko slikanje 
medenice stoje. Naključno so bili razdeljeni v dve skupini 
z enakim številom. Polovica jih je umaknila tkivo s področja 
slikanja, druga polovica pa ne. Pri vseh smo izmerili obseg 
pasu in bokov, telesno višino in maso, DAP, velikost polja, 
razdaljo med goriščem in objektom slikanja, tokovni sunek 
(mAs) in napetost (kV). Naknadno smo iz meritev izračunali še 
indeks telesne mase, vstopno kožno dozo in efektivno dozo. 
Dobljene slike so ocenili trije radiologi. 
Rezultati in razprava: Tanka trikotna ruta ni povzročala 
artefaktov na rentgenogramu. Obseg pasu se je zmanjšal za 
4,7 % po umiku mehkega tkiva, medtem ko je obseg bokov 
ostal enak. V skupini pacientov, ki so umaknili maščobno tkivo 
med preiskavo, se je DAP znižal za 38,5 %, vstopna kožna doza 
za 44 %, efektivna doza pa za 38,7 %. Kolčna sklepa, veliki 
in mali grči stegnenice, sklepna ponvica kolčnega sklepa, 
vratova stegnenice, sredica in skorja kosti medenice, križnica 
in križnične odprtine ter mehka tkiva medenice in kolkov so 
bili bolj vidni na slikah z odmikom mehkega tkiva.
Zaključek: Z umikom maščobnega tkiva se znižajo DAP, 
vstopna kožna doza in efektivna doza, hkrati pa se izboljša 
kakovost slike. 
Ključne besede: slikanje medenice stoje, odmik mehkega 
tkiva, kakovost slike, dozna obremenitev
ABSTRACT
Introduction and purpose: When previous studies compared 
erect pelvic imaging with the supine position, they reported 
lower image quality and higher radiation dose for erect pelvic 
X-ray in larger patients. The purpose of this study was to 
determine whether radiation dose and image quality diff er 
for radiographs of the pelvis in the erect position with and 
without adipose tissue displacement. 
Methods: The fi rst part of the study was performed on a 
phantom in which we determined a band that would not 
produce artefacts on the resulting image when displacing 
fat tissue. The second part was performed on 60 patients 
who were randomly divided into two groups. One group had 
adipose tissue displaced from the pelvic region and the other 
did not. We measured waist and hip circumference, height, 
weight, DAP, primary fi eld size, source-to-skin distance, mAs, 
and kV. We then calculated BMI, ESD, and eff ective dose. The 
images were evaluated by three radiologists. 
Results and Discussion: A thin cotton triangular bandage 
showed no visible artefacts. Thickness around the waist 
decreased by 4.7% after tissue displacement, while hip 
circumference remained the same. In a group of patients 
with tissue displacement, DAP was 38.5% lower, ESD was 
44% lower and eff ective dose was reduced by 38.7%. Hip 
joints, trochanters, acetabula, femoral necks, medulla and 
cortex of the pelvis, pelvic/hip soft tissues, and sacrum and its 
foramina were more visible on images obtained with fat tissue 
displacement. 
Conclusion: When fat tissue was displaced from the pelvic 
region DAP, ESD and the eff ective dose decreased and the 
image quality increased.
Medical Imaging and Radiotherapy Journal (MIRTJ) 39 (Suppl. 1) 19
Medical Imaging and Radiotherapy Journal (MIRTJ) 39 (Suppl. 1)
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