| 丁海岭,王永春,王敏杰.心血管介入手术中透视时间作为辐射剂量警示指标的可行性研究[J].中华放射医学与防护杂志,2020,40(3):237-240 |
| 心血管介入手术中透视时间作为辐射剂量警示指标的可行性研究 |
| Feasibility study of using fluoroscopy time as warning indicator for radiation dose in cardiovascular interventions |
| 投稿时间：2019-05-26 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.03.014 |
| 中文关键词: 心血管介入 辐射剂量 透视时间 |
| 英文关键词:Cardiovascular intervention Radiation dose Fluoroscopy time |
| 基金项目: |
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| 摘要点击次数: 2041 |
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| 中文摘要: |
| 目的 以心血管介入术后采集空气比释动能（reference air kerma，AK）值和剂量面积乘积（dose-area product，DAP）值数据为依据，分析术中透视时间报警设置作为心血管介入手术辐射剂量的监测和警示工具的可行性。方法 回顾性分析2016年11月至2018年1月上海长海医院736例冠状动脉造影术（CAG）和经皮冠状动脉治疗术（PCI）病例，收集术中透视时间、AK和DAP数据资料。德国西门子成像设备分组（Ceiling系统和Biplane系统）和手术类型分组（CAG和PCI），对辐射剂量数据进行比较，以及对心血管介入手术AK和DAP值与透视时间数据采用Spearman检验解析相关性。结果 Ceiling和Biplane成像系统中手术透视时间为（8.9±7.8）和（8.6±7.3）min，透视AK均值和DAP均值分别为（472±474）、（510±509）mGy、（4 548±4 085）和（4 255±3 781）μGy·m2，术中总（透视+造影）AK和DAP均值为（703±595）、（733±614）mGy、（6 253±4 938）和（5 681±4 432）μGy·m2。CAG与PCI术中透视时间均值分别为（2.4±0.9）和（15.7±4.9）min。PCI透视辐射剂量（AK和DAP）与术中总辐射剂量比值分别为74%和78%。心血管介入手术中透视时间与AK值（r=0.822）和DAP值（r=0.844）都呈高度相关性（P<0.001）。结论 透视采集辐射剂量是心血管介入手术中辐射剂量的主要来源，辐射剂量随透视时间延长而增加，透视时间监测和报警设置在心血管介入临床应用中作为术中辐射防护工具有一定的参考和警示价值。 |
| 英文摘要: |
| Objective To collect the date of radiation dose in reference air kerma(AK) and dose-area product (DAP) values in order to evaluate the feasibility of fluoroscopy time as a monitoring and warning indicator of radiation exposure in cardiovascular interventions. Methods The study conducted a retrospective analysis of 736 patients who underwent coronary angiography(CAG)and percutaneous coronary intervention(PCI)from November 2016 to January 2018 in Shanghai Changhai Hospital. Based on the imaging equipments(a Siemens Ceiling system and a Siemens Biplane system)and cardiovascular interventions(CAG and PCI),the fluoroscopy time, AK values and DAP values were collected. The correlation of the radiation dose and fluoroscopy time was analyzed using Spearman correlation statistics. Results The mean values of fluoroscopy time,fluoroscopy AK,total AK,fluoroscopy DAP and total DAP were(8.9±7.8)min,(472±474),(703±595)mGy,(4 578±4 085)and(6 253±4 938)μGy·m2 for Ceiling system and(8.6±7.3)min,(510±509),(733±614)mGy,(4 255±3 781)and (5 681±4 432)μGy·m2 for Biplane system,respectively. The mean values of CAG and PCI fluoroscopy time were(2.4±0.9)and(15.7±4.9)min,respectively.The ratio of fluoroscopy radiation dose (AK and DAP) to total dose was 74% and 78% in PCI procedures. There was a strongly correlation between fluoroscopy time and total AK (r=0.822) or total DAP (r=0.844) in cardiovascular interventions (P<0.001). Conclusions The radiation dose of fluoroscopy acquisition is the main source of overall radiation dose in cardiovascular interventions. Radiation dose is expected to increase as fluoroscopy time increases.The fluoroscopy timer as a protective tool of radiation exposure has a good reference and warning value in the clinical application of cardiovascular interventions. |
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