Seguchi S, Aoyama T, Koyama S, Kawaura C, Fujii K
Graduate School of Medicine, Nagoya University, Higashi-ku, Nagoya, Japan.
Eur Radiol. 2008 Nov;18(11):2559-67. doi: 10.1007/s00330-008-1025-7. Epub 2008 May 20.
The aim of this study was to evaluate entrance skin dose (ESD), organ dose and effective dose to patients undergoing catheter ablation for cardiac arrhythmias, based on the dosimetry in an anthropomorphic phantom. ESD values associated with mean fluoroscopy time and digital cine frames were in a range of 0.12-0.30 Gy in right anterior oblique (RAO) and 0.05-0.40 Gy in left anterior oblique (LAO) projection, the values which were less than a threshold dose of 2 Gy for the onset of skin injury. Organs that received high doses in ablation procedures were lung, followed by bone surface, esophagus, liver and red bone marrow. Doses for lung were 24.8-122.7 mGy, and effective doses were 7.9-34.8 mSv for mean fluoroscopy time of 23.4-92.3 min and digital cine frames of 263-511. Conversion coefficients of dose-area product (DAP) to ESD were 8.7 mGy/(Gy cm(2)) in RAO and 7.4 mGy/(Gy cm(2)) in LAO projection. The coefficients of DAP to the effective dose were 0.37 mSv/(Gy cm(2)) in RAO, and 0.41 mSv/(Gy cm(2)) in LAO projection. These coefficients enabled us to estimate patient exposure in real time by using monitored values of DAP.
本研究的目的是基于拟人化体模中的剂量测定，评估接受心律失常导管消融术患者的体表入射剂量（ESD）、器官剂量和有效剂量。与平均透视时间和数字电影帧数相关的ESD值在右前斜位（RAO）为0.12 - 0.30 Gy，在左前斜位（LAO）为0.05 - 0.40 Gy，这些值低于皮肤损伤起始的阈值剂量2 Gy。在消融手术中接受高剂量的器官依次为肺，其次是骨表面、食管、肝脏和红骨髓。肺的剂量为24.8 - 122.7 mGy，对于平均透视时间23.4 - 92.3分钟和数字电影帧数263 - 511，有效剂量为7.9 - 34.8 mSv。剂量面积乘积（DAP）到ESD的转换系数在RAO为8.7 mGy/(Gy cm²)，在LAO为7.4 mGy/(Gy cm²)。DAP到有效剂量的系数在RAO为0.37 mSv/(Gy cm²)，在LAO为0.41 mSv/(Gy cm²)。这些系数使我们能够通过使用监测到的DAP值实时估计患者的照射剂量。
