Ozpelit Mehmet Emre, Ercan Ertugrul, Ozpelit Ebru, Pekel Nihat, Tengiz Istemihan, Ozyurtlu Ferhat, Yilmaz Akar
Department of Cardiology, Izmir University, Izmir, Turkey.
Department of Cardiology, Dokuz Eylul University, Izmir, Turkey.
Radiat Prot Dosimetry. 2017 Apr 15;173(4):383-388. doi: 10.1093/rpd/ncw028.
Mean radiation exposure in invasive cardiology varies greatly between different centres and interventionists. The International Commission on Radiological Protection and the EURATOM Council stipulate that, despite reference values, 'All medical exposure for radiodiagnostic purposes shall be kept as low as reasonably achievable' (ALARA). The purpose of this study is to establish the effects of the routine application of ALARA principles and to determine operator and procedure impact on radiation exposure in interventional cardiology.
A total of 240 consecutive cardiac interventional procedures were analysed. Five operators performed the procedures, two of whom were working in accordance with ALARA principles (Group 1 operators) with the remaining three working in a standard manner (Group 2 operators). Radiation exposure levels of these two groups were compared.
Total fluoroscopy time and the number of radiographic runs were similar between groups. However, dose area product and cumulative dose were significantly lower in Group 1 when compared with Group 2. Radiation levels of Group 1 were far below even the reference levels in the literature, thus representing an ultra-low-dose radiation exposure in interventional cardiology.
By use of simple radiation reducing techniques, ultra-low-dose radiation exposure is feasible in interventional cardiology. Achievability of such levels depends greatly on operator awareness, desire, knowledge and experience of radiation protection.
不同中心和介入医生在侵入性心脏病学中的平均辐射暴露差异很大。国际放射防护委员会和欧洲原子能共同体理事会规定，尽管有参考值，但“所有用于放射诊断目的的医疗照射应保持在合理可行尽量低的水平”（ALARA原则）。本研究的目的是确定常规应用ALARA原则的效果，并确定操作人员和操作程序对介入性心脏病学中辐射暴露的影响。
共分析了240例连续的心脏介入手术。五名操作人员进行了这些手术，其中两名按照ALARA原则操作（第1组操作人员），其余三名以标准方式操作（第2组操作人员）。比较了这两组的辐射暴露水平。
两组之间的总透视时间和射线照相次数相似。然而，与第2组相比，第1组的剂量面积乘积和累积剂量显著更低。第1组的辐射水平甚至远低于文献中的参考水平，因此代表了介入性心脏病学中的超低剂量辐射暴露。
通过使用简单的辐射减少技术，介入性心脏病学中实现超低剂量辐射暴露是可行的。达到这样的水平很大程度上取决于操作人员对辐射防护的意识、意愿、知识和经验。
