| 孙建忠,王志康,章伟敏,蔡劲松.平板DSA介入检查治疗患者的剂量调查[J].中华放射医学与防护杂志,2011,31(1):83-86 |
| 平板DSA介入检查治疗患者的剂量调查 |
| Radiation doses in interventional radiology procedures |
| 投稿时间：2009-12-02 |
| DOI：10.3760/cma.j.issn.0254-5098.2011.01.024 |
| 中文关键词: 数字减影血管造影 剂量面积 表面剂量 有效剂量 |
| 英文关键词:Digital subtraction angiography Dose area product Cumulative air kerma Effective dose |
| 基金项目:浙江省科学技术厅2010年度省级公益性技术应用研究计划项目(2010C33064);浙江省医药卫生科学研究基金(2009A094) |
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| 中文摘要: |
| 目的 调查平板数字减影血管造影(DSA)介入检查治疗患者的照射剂量,分析影响患者照射剂量的因素。方法 收集2009年3至6月来本院做DSA检查治疗的患者461例,手术种类包括全脑血管造影(CEA)、颅内动脉瘤弹簧圈栓塞(CAE)、肝脏动脉造影+超选化疗(SHAC)、冠状动脉造影(COA)、冠状动脉支架植入(PISI)、心脏射频消融(RFCA)、永久起搏器安装(PCPI)。通过采集所有病例的剂量面积值(DAP)、累计皮肤表面入射剂量(CAK)、透视时间,采用转换因子计算有效剂量值。结果 CEA、CAE、SHAC、COA、PIST、RFCA、PCPI的有效剂量当量分别为(0.33±0.20)、(0.49±0.35)、(6.92±4.19)、(0.76±0.91)、(2.35±1.47)、(0.50±0.74)和(0.67±0.70) Sv;461例患者中超过1 Sv的达到120人次,占26%,超过10 Sv的达到10人次,均为SHAC患者。CAK分别为(0.55±0.43)、(1.34±1.11)、(0.95±0.57)、(0.32±0.31)、(0.91±0.33)、(0.16±0.22)和(0.15±0.14)Gy,CAK值超过1 Gy共为59例,占12.8%,超过2 Gy为11例,占2.4%,有2例超过3 Gy,为4.5和6.1 Gy,分别为CEA和CAE患者。结论 各项介入手术患者所受照射剂量个体差异较大。介入检查治疗患者接受的照射剂量较高,需要进行严格的监督以保证患者照射剂量得到最佳控制。 |
| 英文摘要: |
| Objective To investigate the radiation doses for the patients undergoing interventional radiology and to analyze the dose-influencing factors. Methods The clinical data of 461 patients undergoing interventional radiology, including cerebral angiography(CEA), cerebral aneurysm embolism(CAE), superselective hepatic arterial chemoembolization (SHAC), coronary angiography(COA), percutaneous intracoronary stent implantation(PISI), cardiac radiofrequency catheter ablation (RFCA), and permanent cardiac pacemaker implantation(PCPI) were collected to observe the cumulative air kerma (CAK), dose area product (DAP), and fluoroscopy time, and effective dose was estimated using the conversion factors. Results The effective doses for CEA, CAE, SHAC, COA, PISI, RFCA, and PCPI were (0.33±0.20), (0.49±0.35), (6.92±4.19), (0.76±0.91), (2.35±1.47), (0.50±0.74), and (0.67±0.70) Sv, respectively. In 126 of the 416 patients (26%), the effective doses were greater than 1 Sv, and the effective doses of 10 person-times were greater than 10 Sv, all of which were observed in the patients undergoing SHAC. The CAK values for CEA, CAE, SHAC, COA, PISI, RFCA, and PCPI were (0.55±0.43), (1.34±1.11), (0.95±0.57), (0.32±0.31), (0.91±0.33), (0.16±0.22), and (0.15±0.14) Gy, respectively. The CAK values were greater than 1 Gy in 59 of the 461 patients (12.8%), greater than 2 Gy in 11 cases (2.4%), and greater than 3 Gy in 1 CEA cases and 1 CEA case, respectively. Conclusions There is a wide variation range in radiation dose for different procedures. As most interventional radiology procedure can result in clinically significant radiation dose to the patient, stricter dose control should be carried out. |
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