Department of Medical Physics, AUSL di Piacenza, 29100 Piacenza, Italy.
Phys Med. 2010 Oct;26(4):224-32. doi: 10.1016/j.ejmp.2010.01.001. Epub 2010 Feb 8.
The aim of this study was to evaluate the maximum skin dose (MSD) in patients undergoing interventional cardiology procedures, obtaining local reference levels and comparing these with the reference levels proposed in the literature. The patients' MSD was measured using Gafchromic XR type R films. In order to evaluate reference levels, the number of images acquired, the fluoroscopy times and the KAP(TOTAL) were recorded for each procedure. For the evaluation of the MSD, 8 coronary angiography (CA) and 16 percutaneous transluminal coronary angioplasty (PTCA) procedures, carried out in the period from May to June 2008, were analyzed. For the CA procedures the MSD values were below 0.5 Gy. For the PTCA procedures, we found a fairly good correlation between fluoroscopy time and MSD (r = 0.80, p = 0.0002) and between MSD and WFP (r = 0.863, p < 0.0001); there was a strong correlation between KAP(TOTAL) and MSD (r = 0.904, p <0.0001). Since the correlation between KAP(TOTAL) and MSD is more striking than that with fluoroscopic time and the WFP, KAP measurements are suitable for online skin dosimetry and may, therefore, be used to avoid radiation-induced skin injuries. A MSD greater than 3 Gy occurred in only one procedure. For calculus of the local reference levels, we extended the data-gathering to 30 procedure CA and to 40 PTCA: we compared local practice with that in other centers using the guidance levels proposed by Balter et al. Our median KAP values were below these proposed guidance levels; our mean KAP values were above these proposed action levels. From a first application of the proposed reference levels, it appears that, according to the recommendations of Balter et al. an investigation into local practice is not necessary.
本研究旨在评估接受介入心脏病学治疗的患者的最大皮肤剂量（MSD），获取局部参考水平并将其与文献中提出的参考水平进行比较。使用 Gafchromic XR 型 R 胶片测量患者的 MSD。为了评估参考水平，记录了每个程序采集的图像数量、透视时间和 KAP（TOTAL）。为了评估 MSD，分析了 2008 年 5 月至 6 月期间进行的 8 例冠状动脉造影（CA）和 16 例经皮腔内冠状动脉成形术（PTCA）。对于 CA 程序，MSD 值低于 0.5Gy。对于 PTCA 程序，我们发现透视时间和 MSD 之间存在很好的相关性（r=0.80，p=0.0002），MSD 和 WFP 之间也存在很好的相关性（r=0.863，p<0.0001）；KAP（TOTAL）和 MSD 之间存在很强的相关性（r=0.904，p<0.0001）。由于 KAP（TOTAL）与 MSD 之间的相关性比透视时间和 WFP 更为显著，因此 KAP 测量适用于在线皮肤剂量测定，可用于避免辐射引起的皮肤损伤。只有 1 例程序的 MSD 大于 3Gy。为了计算局部参考水平，我们将数据采集扩展到 30 例 CA 和 40 例 PTCA：我们使用 Balter 等人提出的指导水平将本地实践与其他中心进行了比较。我们的中位数 KAP 值低于这些建议的指导水平；我们的平均 KAP 值高于这些建议的行动水平。根据 Balter 等人的建议，首次应用提出的参考水平表明，无需对本地实践进行调查。
