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血管外科患者血管内治疗以外的辐射暴露。

Radiation exposure of vascular surgery patients beyond endovascular procedures.

机构信息

Department of Surgery, Division of Vascular Surgery, Stanford University, Stanford, CA 94305-5642, USA.

出版信息

J Vasc Surg. 2011 Jan;53(1 Suppl):39S-43S. doi: 10.1016/j.jvs.2010.06.176. Epub 2010 Sep 16.

Abstract

BACKGROUND

Medical imaging evaluations provide valuable information and are often imperative in the care of our patients. Radiation exposure in patients who undergo medical imaging procedures is not routinely monitored and the associated risks are often underestimated.

METHODS

Radiation exposure associated with computed tomography (CT) angiography and coronary intervention is reviewed.

RESULTS

Vascular surgeons are often involved in the decision-making process in roughly 30% of CT scans performed that are believed to be unnecessary. Society for Vascular Surgery (SVS) practice guidelines for patients with abdominal aortic aneurysms recommended eliminating a 6-month contrast surveillance CT if no endoleak was observed at 1 month after endovascular aneurysm repair (EVAR). Ultrasound and aortic duplex can help eliminate some of the CT scans.

CONCLUSION

Vascular surgeons must remain vigilant in monitoring radiation exposure for their patients who have potential for coronary and vascular imaging with radiation. Judicious use of alternative imaging modalities when possible and maintaining the dose as low as reasonably achievable (ALARA) is the responsibility of vascular surgeons.

摘要

背景

医学影像学评估提供了有价值的信息,在患者的治疗中通常是必不可少的。接受医学影像学检查的患者的辐射暴露通常没有得到常规监测,相关风险常常被低估。

方法

对计算机断层扫描(CT)血管造影和冠状动脉介入术相关的辐射暴露进行了回顾。

结果

血管外科医生经常参与约 30%的 CT 扫描决策过程,这些扫描被认为是不必要的。血管外科学会(SVS)针对腹主动脉瘤患者的实践指南建议,如果血管内修复(EVAR)后 1 个月未观察到内漏,则消除 6 个月的对比随访 CT。超声和主动脉双功能超声可以帮助消除一些 CT 扫描。

结论

血管外科医生必须对有潜在冠状动脉和血管成像辐射风险的患者保持警惕,监测其辐射暴露。在可能的情况下明智地使用替代成像方式,并将剂量控制在合理可行的最低水平(ALARA)是血管外科医生的责任。

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