Larsen Anne Sofie F, Osterås Bjørn Helge
Østfold Hospital Trust, Department of Radiology, University of Oslo, Norway.
Acta Radiol. 2012 Apr 1;53(3):330-4. doi: 10.1258/ar.2011.110560. Epub 2012 Feb 14.
During arterial interventional procedures, power injectors allow the operator to step back from the patient or exit the angiography suite during digital subtraction angiography (DSA) acquisitions. Increasing the distance to the radiation source reduces exposure to the operator and staff.
To systematically investigate the effect of increasing the distance between the radiation source and the operator during DSA acquisitions in a daily clinical setting, regarding radiation exposure to the operator and patient, as well as the duration of the procedure using a power injector to deliver contrast media.
Patients scheduled for arterial interventional procedures in the pelvis or lower extremities were consecutively included. In phase one (duration 6 weeks, 44 patients) contrast media were injected manually. In phase two (duration until the total dose area product [DAP] was equal to phase 1, 41 patients) the operator used a power injector and exited the suite whenever possible. Patient, procedure, and examination data were recorded. Collective dose to the operator's collar, lead apron, and hands was recorded using thermo luminescent dosimetry (TLD).
Our results showed a dose reduction of 50% to the operator's hands, lead apron, and thyroid collar when using a power injector during DSA, with no significant increase in DAP or procedure time when performing pelvic procedures. For lower extremity procedures there was a small but significant increase in procedure time and DAP. Pelvic procedures yielded substantially higher DAP than lower extremity procedures during both phases.
Utilization of a power injector, thus allowing the operator to step back from the patient, facilitates a radiation dose reduction to the operator of approximately 50% with no significant increase in patient dose or procedure time during pelvic procedures.
在动脉介入手术过程中，电动注射器使操作人员在数字减影血管造影（DSA）采集期间能够远离患者或离开血管造影室。增加与辐射源的距离可减少操作人员和工作人员所受的辐射。
在日常临床环境中，系统研究在DSA采集期间增加辐射源与操作人员之间的距离对操作人员和患者辐射暴露的影响，以及使用电动注射器注入造影剂时手术的持续时间。
连续纳入计划进行骨盆或下肢动脉介入手术的患者。在第一阶段（持续6周，44例患者），手动注射造影剂。在第二阶段（持续至总剂量面积乘积[DAP]等于第一阶段，41例患者），操作人员使用电动注射器并尽可能离开手术室。记录患者、手术和检查数据。使用热释光剂量测定法（TLD）记录操作人员领口、铅围裙和手部的集体剂量。
我们的结果显示，在DSA期间使用电动注射器时，操作人员手部、铅围裙和甲状腺领口的剂量降低了50%，在进行骨盆手术时，DAP或手术时间没有显著增加。对于下肢手术，手术时间和DAP有小幅但显著的增加。在两个阶段中，骨盆手术产生的DAP均显著高于下肢手术。
使用电动注射器，从而使操作人员能够远离患者，有助于将操作人员的辐射剂量降低约50%，而在骨盆手术期间患者剂量或手术时间没有显著增加。
