Suzuki S, Furui S, Matsumaru Y, Nobuyuki S, Ebara M, Abe T, Itoh D
Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan.
AJNR Am J Neuroradiol. 2008 Jun;29(6):1076-81. doi: 10.3174/ajnr.A1045. Epub 2008 Apr 3.
Although neuroembolization has recently spread quickly, sufficient attention has not been focused on the associated radiation exposure. The purpose of this research was to evaluate the patient's entrance skin dose (ESD) during neuroembolizations in 6 institutions.
This study was approved by all of the 6 institutional review boards, and all of the patients gave informed consent. This study included a total of 103 consecutive neuroembolizations in the 6 institutions. Patient ESDs during the procedures were evaluated by using caps that had 44 radiosensitive indicators adherent to the surface. The patient ESDs were calculated from the color difference of the indicators. To check for effects on the scalp, clinical follow-up was performed at 1-2 days, 2 weeks, and 3 months after the procedure.
The averages of total fluoroscopic time, total number of digital subtraction angiography frames, and dose area product were 67.1 +/- 41.6 minutes, 883 +/- 626, and 257 +/- 150 Gy x cm(2), respectively. The average maximum ESD for each patient was 1.9 +/- 1.1 Gy (range, 0.4-5.6 Gy; median, 1.5 Gy). The average maximum ESDs of each institution ranged from 1.0 to 2.4 Gy. Epilation was observed in 6 patients.
The maximum ESDs during neuroembolizations exceed the thresholds for radiation skin injuries in some cases.
尽管神经栓塞术近来迅速普及,但对其相关辐射暴露尚未给予足够关注。本研究的目的是评估6家机构在神经栓塞术过程中患者的体表入口剂量(ESD)。
本研究获得了所有6家机构伦理审查委员会的批准,所有患者均签署了知情同意书。本研究共纳入了6家机构连续进行的103例神经栓塞术。术中通过使用表面粘贴有44个放射敏感指示剂的帽状物来评估患者的ESD。根据指示剂的颜色差异计算患者的ESD。为检查对头皮的影响,术后1 - 2天、2周和3个月进行临床随访。
透视总时间、数字减影血管造影帧数总和以及剂量面积乘积的平均值分别为67.1±41.6分钟、883±626以及257±150 Gy×cm²。每位患者的平均最大ESD为1.9±1.1 Gy(范围为0.4 - 5.6 Gy;中位数为1.5 Gy)。各机构的平均最大ESD范围为1.0至2.4 Gy。6例患者出现脱发。
在某些情况下,神经栓塞术期间的最大ESD超过了放射性皮肤损伤的阈值。