Chida Koichi, Saito Haruo, Kagaya Yutaka, Kohzuki Masahiro, Takai Yoshihiro, Takahashi Shoki, Yamada Shogo, Zuguchi Masayuki
Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Tohoku University, Sendai, Japan.
Catheter Cardiovasc Interv. 2006 Aug;68(2):236-41. doi: 10.1002/ccd.20830.
To evaluate whether the maximum radiation dose to the patient's skin (MSD) can be estimated during percutaneous coronary intervention (PCI) procedures, we investigated the relationship between the MSD and fluoroscopic time, dose-area product (DAP), and body weight, separately analyzing the relationships for different target vessels.
Many cases of skin injury caused by excessive radiation exposure during cardiac intervention procedures have been reported. However, real-time maximum-dose monitoring of the skin is unavailable for many cardiac intervention procedures.
We studied 197 consecutive PCI procedures that involved a single target vessel and were conducted. The DAP was measured, and the MSD was calculated by a skin-dose mapping software program (Caregraph). The target vessels of the PCI procedures were divided into four groups based on the AHA classification system: AHA 5-10, left anterior descending artery domain (LAD), AHA 11-15, left circumflex artery domain (LCx), AHA 1-3 = R 1-3, and AHA 4 = R 4.
The correlation coefficient (r) between the MSD and fluoroscopic time was higher for the right coronary artery (RCA) vessels (R 1-3, 0.852; R 4, 0.715) than for the left coronary artery (LCA) vessels (LAD, 0.527; LCx, 0.646), and the r value between the MSD and DAP was higher for the RCA vessels (R 1-3, 0.871; R 4, 0.898) than for the LCA vessels (LAD, 0.628; LCx, 0.694). Similarly, the correlation coefficient between the MSD and weight x fluoroscopic time (WFP) was higher for the RCA vessels (R 1-3, 0.874; R 4, 0.807) than for the LCA vessels (LAD, 0.551; LCx, 0.735).
The DAP and WFP can be used to estimate the MSD during PCI in the RCA but not in the LCA, especially the LAD.
为了评估在经皮冠状动脉介入治疗（PCI）过程中是否能够估算患者皮肤所接受的最大辐射剂量（MSD），我们研究了MSD与透视时间、剂量面积乘积（DAP）和体重之间的关系，并分别分析了不同靶血管的这些关系。
已有许多关于心脏介入手术期间因过度辐射暴露导致皮肤损伤的病例报道。然而，许多心脏介入手术无法进行皮肤实时最大剂量监测。
我们研究了连续进行的197例涉及单一靶血管的PCI手术。测量了DAP，并通过皮肤剂量映射软件程序（Caregraph）计算了MSD。根据美国心脏协会（AHA）分类系统，将PCI手术的靶血管分为四组：AHA 5 - 10，左前降支动脉区域（LAD）；AHA 11 - 15，左旋支动脉区域（LCx）；AHA 1 - 3 = R 1 - 3；AHA 4 = R 4。
右冠状动脉（RCA）血管（R 1 - 3，0.852；R 4，0.715）的MSD与透视时间之间的相关系数（r）高于左冠状动脉（LCA）血管（LAD，0.527；LCx，0.646），并且RCA血管（R 1 - 3，0.871；R 4，0.898）的MSD与DAP之间的r值高于LCA血管（LAD，0.628；LCx，0.694）。同样，RCA血管（R 1 - 3，0.874；R 4，0.807）的MSD与体重×透视时间（WFP）之间的相关系数高于LCA血管（LAD，0.551；LCx，0.735）。
DAP和WFP可用于估算RCA的PCI过程中的MSD，但不能用于LCA，尤其是LAD。
