Seifert H, Roth R, Urbanczyk K, Kramann B
Abteilung für Strahlentherapie, Universitätskliniken des Saarlandes, Homburg.
Rofo. 1999 Feb;170(2):185-90.
To determine and judge patient doses caused by selected interventional and angiographic procedures using the "Multiskip" digital C-arm unit.
The dose-area product and the fluoroscopic time were measured for 71 percutaneous transluminal angioplasties (PTA), 33 PTA with stent implantation, and 37 embolizations; in addition, they were also measured for 285 digital subtraction angiographies (DSA). In the case of 13 PTA, 10 embolizations, and 33 DSA the number of radiographs was determined, and the dose-area product was divided into two parts, fluoroscopy and radiography, applying a computer programme.
The median values of the dose-area product and the fluoroscopic time amounted to 36 Gy cm2 and 11.5 min for PTA, 131 Gy cm2 and 14.4 min for PTA with stent implantation, 197 Gy cm2 and 24.5 min for embolisation as well as 87 Gy cm2 and 3.7 min for DSA. For the relation between dose-area products caused by fluoroscopy and radiography and the number of radiographs, median values of 0.67 and 70 for PTA, 0.58 and 153 for embolisation as well as 1.35 and 135 for DSA were determined.
To reduce the relatively high patient doses the modification of the C-arm unit is aspired to realize pulsed fluoroscopy and automatic filter selection. Also experimental investigations will be done related to additional filtration and reduction of the image intensifier input dose rate and dose per frame, respectively. Then, the effect of dose reduction caused by these measures will be confirmed in a comparable patient study.
使用“多跳”数字C形臂设备测定并判断特定介入和血管造影手术所导致的患者剂量。
对71例经皮腔内血管成形术(PTA)、33例带支架植入的PTA以及37例栓塞术测量了剂量面积乘积和透视时间;此外,还对285例数字减影血管造影(DSA)进行了测量。对于13例PTA、10例栓塞术和33例DSA,确定了射线照片数量,并通过计算机程序将剂量面积乘积分为透视和射线照相两部分。
PTA的剂量面积乘积和透视时间的中位数分别为36 Gy cm²和11.5分钟,带支架植入的PTA为131 Gy cm²和14.4分钟,栓塞术为197 Gy cm²和24.5分钟,DSA为87 Gy cm²和3.7分钟。对于透视和射线照相所导致的剂量面积乘积与射线照片数量之间的关系,PTA的中位数分别为0.67和70,栓塞术为0.58和153,DSA为1.35和135。
为降低相对较高的患者剂量,期望对C形臂设备进行改进以实现脉冲透视和自动滤过选择。还将分别针对额外滤过以及降低图像增强器输入剂量率和每帧剂量进行实验研究。然后,将在一项可比的患者研究中证实这些措施所导致的剂量降低效果。