건강검진 목적으로 심장 CT검사를 시행한 198명의 대상자 중 수동노출조절 방법(n=123)의 대조군과 자동노출조절 방법(n=75)의 실험군으로 BMI에 따라 Grade 1(BMI < 23kg/$m^2$), Grade 2(23 $$leq_-$$ BMI < 25kg/$m^2$), Grade 3(25 $$leq_-$$ BMI < 30kg/$m^2$), Grade 4(30 $$leq_-$$ BMI kg/$m^2$)로 분류하고 영상의 질을 객관적, 주관적 평가로 분석하였고 방사선량을 비교하였다. 자동노출조절 방법을 사용하였을 때 모든 Grade에서 관전압이 유의하게 감소하였고, $CTDI_{vol}$, effective dose 값은 Grade 2에서는 통계적으로 유의하지 않게 감소하였으나 Grade 1, 3, 4에서는 유의하게 감소하였다(p<0.05). SNR은 Grade 1에서 유의하게 감소하였고 Grade 3에서는 유의하게 증가하였지만(p<0.05) Grade 2와 4에서는 유의한 차이가 없었다(p>0.05). CNR은 Grade 1에서 유의하게 감소하였고(p<0.05), Grade 2, 3, 4에서는 유의한 차이는 없었다(p>0.05). 영상의 주관적인 평가에서도 두 그룹간의 모든 Grade에서 유의한 차이가 없었다(p>0.05). 결론적으로 자동노출조절 방법은 수동노출조절 방법에 비해 영상의 주관적 평가는 변하지 않으면서도 피폭선량을 줄일 수 있는 유용한 방법으로 나타났다.
This study included 198 patients who underwent prospectively electrocardiogram-triggered high-pitch spiral mode(FLASH mode) in cardiac CT for health check: 123 patients who underwent manual exposure control(Group A) and 75 patients who underwent automatic exposure control(Group B). Patients were classified according to BMI grades: Grade 1, Grade 2, Grade 3, Grade 4. Radiation dose, objective and subjective image quality between two groups were compared. In Group B, tube voltage were significantly decreased in all BMI grades. Both $CTDI_{vol}$ and effective dose were significantly reduced in the BMI Grade 1, 3, and 4 whereas they were slightly reduced in the Grade 2(p>0.05), SNR was significantly decreased in the Grade 1 and increased in the Grade 3(p<0.05), but there was no significant difference in the Grade 2, 4 between the two groups(p>0.05). CNR was significantly decreased in the Grade 1(p<0.05), and there was no significant difference in the Grade 2, 3, 4 between the two groups(p>0.05). The subjective image quality showed no significant difference in all BMI Grades between the two groups(p>0.05). Automatic exposure control can lead to a significant reduction of radiation exposure dose without degradation of subjective image quality.
