优化策略与依据：子宫肌瘤子宫动脉栓塞术的一个实例
Optimisation strategies and justification: an example in uterine artery embolisation for fibroids.
作者信息
Vetter S, Schultz F W, Strecker E-P, Zoetelief J
机构信息
Department of Radiology, Diakonissenkrankenhaus, Diakonissenstrasse 28, D-76199 Karlsruhe, Germany.
出版信息
Radiat Prot Dosimetry. 2005;117(1-3):50-3. doi: 10.1093/rpd/nci717. Epub 2006 Feb 3.
Radiation risk has to be justified and optimised. This study discusses the radiation risk of uterine artery embolisation (UAE) for the treatment of fibroids. A total of 70 consecutive UAE dosimetry parameters were assessed. Using Monte Carlo simulation, organ and effective doses and dose conversion coefficients (DCCs) (mSv Gy cm(-2)) were calculated. During UAE optimisation, avoidance of oblique views and use of last-image-hold (LIH) documentation instead of digital subtraction angiography (DSA) were investigated. Mean dose-area product (DAP) was 37.1 Gy cm2 (median 23.7 Gy cm2) and mean fluoroscopy time was 18.4 min (median 16.6 min). Dose values decreased as the study progressed: mean DAP for patients 1-21, 68.5 Gy cm2; patients 22-43, 35.7 Gy cm2; and patients 44-69, 13.0 Gy cm2. Average DCC for DSA image procedures was 0.572, yielding a mean effective dose of 29.6 mSv (median 17.1 mSv). For LIH-only procedures, an average DCC of 0.813 was estimated [using mean effective dose: 10.6 mSv (median 8.1 mSv)].
辐射风险必须经过论证并加以优化。本研究探讨了子宫动脉栓塞术（UAE）治疗子宫肌瘤的辐射风险。共评估了70个连续的UAE剂量测定参数。使用蒙特卡罗模拟计算了器官剂量、有效剂量和剂量转换系数（DCCs）（mSv Gy cm⁻²）。在UAE优化过程中，研究了避免使用斜位视图以及使用最后图像保持（LIH）记录而非数字减影血管造影（DSA）的情况。平均剂量面积乘积（DAP）为37.1 Gy cm²（中位数为23.7 Gy cm²），平均透视时间为18.4分钟（中位数为16.6分钟）。随着研究的进行，剂量值下降：第1 - 21例患者的平均DAP为68.5 Gy cm²；第22 - 43例患者为35.7 Gy cm²；第44 - 69例患者为13.0 Gy cm²。DSA图像程序的平均DCC为0.572，平均有效剂量为29.6 mSv（中位数为17.1 mSv）。对于仅使用LIH的程序，估计平均DCC为0.813 [使用平均有效剂量：10.6 mSv（中位数为8.1 mSv）]。
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