Tsalafoutas Ioannis A, Goni Helen, Maniatis Petros N, Pappas Paris, Bouzas Nick, Tzortzis George
Medical Physics Department, Laiko Hospital, Athens, Greece.
J Vasc Interv Radiol. 2006 Sep;17(9):1489-98. doi: 10.1097/01.RVI.0000233526.17393.E4.
To determine the patient doses during noncardiac diagnostic and therapeutic interventional procedures carried out in a dedicated angiographic unit.
For 1,214 interventional procedures, the technique type, dose-area product (DAP), cumulative dose (CD), and fluoroscopy time were recorded. These procedures were classified into 23 categories (10 diagnostic and 13 therapeutic) that included nine to 259 patients each. For each category, descriptive statistical analysis was used to determine the characteristics of DAP, CD, and fluoroscopy time distributions. The statistical significance of the differences observed between categories in terms of DAP was assessed.
For the 23 categories studied, the median DAP values ranged from 0.2 to 176.8 Gycm(2). In comparison with the literature, the mean and median DAP values in this study were within reported ranges for eight categories, greater for three, and less for six, whereas for the remaining six categories no relevant data were found in the literature.
Overall, the results of this survey indicate that the techniques used by the interventionalists, the operation skills of radiation technologists, and the performance of the x-ray unit present no obvious deficiencies in terms of patient radiation protection. However, for those procedures in which lower DAP values were found in the literature, it should be further investigated whether patient doses could be reduced without degradation of the diagnostic and therapeutic outcomes.
确定在专用血管造影设备上进行的非心脏诊断和治疗性介入操作过程中的患者剂量。
对1214例介入操作,记录技术类型、剂量面积乘积(DAP)、累积剂量(CD)和透视时间。这些操作分为23类(10类诊断性和13类治疗性),每类包括9至259例患者。对于每一类,采用描述性统计分析来确定DAP、CD和透视时间分布的特征。评估了各类之间在DAP方面观察到的差异的统计学显著性。
在所研究的23类中,DAP中位数范围为0.2至176.8 Gycm²。与文献相比,本研究中的DAP均值和中位数在八类报告范围内,三类较高,六类较低,而其余六类在文献中未找到相关数据。
总体而言,本次调查结果表明,介入医生使用的技术、放射技师的操作技能以及X射线设备的性能在患者辐射防护方面没有明显缺陷。然而,对于文献中发现DAP值较低的那些操作,应进一步研究是否可以在不降低诊断和治疗效果的情况下降低患者剂量。