Bar Olivier, Maccia Carlo, Pagès Pierre, Blanchard Didier
Clinique Saint Gatien, Tours, France.
EuroIntervention. 2008 Mar;3(5):593-9. doi: 10.4244/eijv3i5a107.
A tentative evaluation of doses received by patients undergoing international cardiolfgy (IC) procedures was carried out in France in June 2006 by the GACI. A pilot survey was performed aiming at: a) demonstrating the feasibility of the adopted approach towards estimating patient exposure; b) getting a first estimate of national diagnostic reference level (DRL) values; c) gathering experience on data collection in view of nationwide future studies.
Nineteen catheterisation laboratories provided data on 813 IC procedures (496 coronarography (CA) and 317 PTCA) performed by 60 cardiologists on 29 different installations. Data gathered for each procedure were: patient characteristics, dosimetry indicators (DosexArea Product, fluoroscopy time, number of frames) and examination details (number of severe lesions, number of stents, etc.). In spite of their overall compliance with international DRL values, dosimetric indicators showed large variations. Maximum to minimum ratios ranged from 60 to 160 for the DAP, from 80 to 60 for the fluoroscopy time and from 25 to 30 for the number of images for CA and PTCA respectively.
Findings highlighted key aspects of IC practice which should be improved from the radiation protection point of view: training of cardiologists, awareness of equipment performance and optimisation of procedures.
2006年6月，法国心血管介入学会（GACI）对接受国际心血管介入（IC）手术的患者所接受的剂量进行了初步评估。开展了一项试点调查，旨在：a）证明所采用的估算患者受照剂量方法的可行性；b）初步估算国家诊断参考水平（DRL）值；c）积累数据收集方面的经验，为未来全国性研究做准备。
19个心导管实验室提供了60位心脏病专家在29个不同设备上进行的813例IC手术（496例冠状动脉造影（CA）和317例经皮冠状动脉腔内血管成形术（PTCA））的数据。为每个手术收集的数据包括：患者特征、剂量学指标（剂量面积乘积、透视时间、帧数）和检查细节（严重病变数量、支架数量等）。尽管剂量学指标总体上符合国际DRL值，但仍存在很大差异。CA和PTCA的剂量面积乘积的最大与最小比值分别为60至160、透视时间的最大与最小比值为80至60、图像数量的最大与最小比值分别为25至30。
研究结果突出了IC手术操作中从辐射防护角度应改进的关键方面：心脏病专家培训、设备性能意识和手术操作优化。
