Efstathopoulos Efstathios P, Katritsis Demosthenes G, Kottou Sofia, Kalivas Nectarios, Tzanalaridou Efthalia, Giazitzoglou Eleftherios, Korovesis Socrates, Faulkner Keith
2nd Department of Radiology, Medical Physics Unit, University of Athens, Athens, Greece.
Europace. 2006 Jun;8(6):443-8. doi: 10.1093/europace/eul041. Epub 2006 May 11.
To perform a comprehensive analysis of all aspects of patient and in-room personnel radiation dosimetry in interventional electrophysiology.
Measurements were performed during 19 diagnostic electrophysiology studies and 24 catheter ablations. Kerma-area product and exposure time values were 48.7 (6.4-230) Gy cm2 and 25.5 (4.4-79.2) min for ablation, and 12.5 (4.5-117.2) Gy cm2 and 4.5 (1.2-31) min for diagnostic studies, respectively. Patient effective doses were 15.2 (2.1-59.6) mSv for ablation and 3.2 (1.3-23.9) mSv for diagnostic procedures. Radiation risk to the patient was estimated to be up to eight cases of fatal cancer in 10,000 procedures. The risk of development of fatal cancer was less than 3x10(-6) per procedure to the primary operator. The risk for the nurse and technician was much lower. The dose per procedure for the primary operator was 7.1 microGy at the eyes, 0.79 microGy at the chest under the lead apron, 13.68 microGy at the chest over the apron, 3.82 microGy at the thyroid, 17.76 microGy at the left hand, and 12.11 microGy at the left knee.
As far as radiation exposure is concerned, electrophysiology studies followed by radiofrequency ablation are safe procedures for both patient and personnel when performed in catheterization laboratories with modern equipment, experienced operators, and standard safety precautions.
对介入电生理学中患者及室内人员辐射剂量测定的各个方面进行全面分析。
在19项诊断性电生理学研究和24例导管消融术中进行了测量。消融术的比释动能面积乘积和照射时间值分别为48.7(6.4 - 230)Gy·cm²和25.5(4.4 - 79.2)分钟,诊断性研究的比释动能面积乘积和照射时间值分别为12.5(4.5 - 117.2)Gy·cm²和4.5(1.2 - 31)分钟。消融术患者的有效剂量为15.2(2.1 - 59.6)mSv,诊断性操作患者的有效剂量为3.2(1.3 - 23.9)mSv。估计在10000例手术中,患者发生致命癌症的风险高达8例。主操作者每例手术发生致命癌症的风险小于3×10⁻⁶。护士和技术人员的风险要低得多。主操作者每例手术眼睛的剂量为7.1微Gy,铅衣下胸部的剂量为0.79微Gy,铅衣上胸部的剂量为13.68微Gy,甲状腺的剂量为3.82微Gy,左手的剂量为17.76微Gy,左膝的剂量为12.11微Gy。
就辐射暴露而言,在配备现代设备、经验丰富的操作者并采取标准安全防护措施的导管实验室中进行电生理学研究及随后的射频消融术,对患者和人员来说都是安全的手术。