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儿科心脏介入手术的局部参考水平和器官剂量。

Local reference levels and organ doses from pediatric cardiac interventional procedures.

作者信息

Barnaoui S, Rehel J L, Baysson H, Boudjemline Y, Girodon B, Bernier M O, Bonnet D, Aubert B

机构信息

Medical Radiation Protection Expertise Unit, Institute of Radioprotection and Nuclear Safety, Fontenay-aux-Roses, France.

出版信息

Pediatr Cardiol. 2014 Aug;35(6):1037-45. doi: 10.1007/s00246-014-0895-5. Epub 2014 Mar 21.

Abstract

Interventional cardiology (IC) procedures can be responsible for relatively high radiation doses compared to conventional radiology especially for young patients. The aim of this study was to assess current exposure levels in a French reference centre of pediatric IC. Dosimetric data including dose area product (DAP), fluoroscopy time (FT) and number of cine frame (NF) were analysed taking into account patient weight. Doses to the lungs, esophagus, breast and thyroid were evaluated using anthropomorphic phantoms and thermoluminescent dosimeters. Finally, effective doses (E) were calculated using DAP and conversion factors calculated with PCXMC 2.0 software. 801 IC procedures performed between 2010 and 2011 were analysed. Large variations were observed for DAP, FT and NF values for a given procedure and a given weight group. The assessment of organ doses showed high levels of dose to the lungs and esophagus especially in new-born babies. For diagnostic procedures, E varied from 0.3 to 23 mSv with a mean value of 4.8 mSv and for therapeutic procedures, values ranged from 0.1 to 48.4 mSv with a mean value of 7.3 mSv. The highest values were recorded for angioplasty procedures (mean 13 mSv, range 0.6-48.4 mSv). The increasing use of IC in pediatric population stresses the need of setting up reference levels and keeping doses to children as low as possible.

摘要

与传统放射学相比,介入心脏病学(IC)手术可能会导致相对较高的辐射剂量,尤其是对于年轻患者。本研究的目的是评估法国一家儿科IC参考中心的当前辐射暴露水平。考虑到患者体重,对包括剂量面积乘积(DAP)、透视时间(FT)和电影帧数(NF)在内的剂量学数据进行了分析。使用人体模型和热释光剂量计评估了肺部、食管、乳房和甲状腺的剂量。最后,使用DAP和通过PCXMC 2.0软件计算的转换因子计算有效剂量(E)。分析了2010年至2011年期间进行的801例IC手术。对于给定的手术和给定的体重组,观察到DAP、FT和NF值存在很大差异。器官剂量评估显示,肺部和食管的剂量水平很高,尤其是在新生儿中。对于诊断手术,E值在0.3至23 mSv之间,平均值为4.8 mSv;对于治疗手术,E值在0.1至48.4 mSv之间,平均值为7.3 mSv。血管成形术手术记录的E值最高(平均13 mSv,范围0.6 - 48.4 mSv)。儿科人群中IC手术的使用日益增加,凸显了设定参考水平并将儿童剂量保持在尽可能低水平的必要性。

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