Kastrati Mirlind, Langenbrink Lukas, Piatkowski Michal, Michaelsen Jochen, Reimann Doris, Hoffmann Rainer
Department of Cardiology, Angiology and Sleep Medicine, Bonifatius Hospital Lingen, Lingen, Germany.
Department of Cardiology, Angiology and Sleep Medicine, Bonifatius Hospital Lingen, Lingen, Germany.
Am J Cardiol. 2016 Aug 1;118(3):353-6. doi: 10.1016/j.amjcard.2016.05.011. Epub 2016 May 14.
This study sought to quantitatively evaluate the reduction of radiation dose in coronary angiography and angioplasty with the use of image noise reduction technology in a routine clinical setting. Radiation dose data from consecutive 605 coronary procedures (397 consecutive coronary angiograms and 208 consecutive coronary interventions) performed from October 2014 to April 2015 on a coronary angiography system with noise reduction technology (Allura Clarity IQ) were collected. For comparison, radiation dose data from consecutive 695 coronary procedures (435 coronary angiograms and 260 coronary interventions) performed on a conventional coronary angiography system from October 2013 to April 2014 were evaluated. Patient radiation dosage was evaluated based on the cumulative dose area product. Operators and operator practice did not change between the 2 evaluated periods. Patient characteristics were collected to evaluate similarity of patient groups. Image quality was evaluated on a 5-grade scale in 30 patients of each group. There were no significant differences between the 2 evaluated groups in gender, age, weight, and fluoroscopy time (6.8 ± 6.1 vs 6.9 ± 6.3 minutes, not significant). The dose area product was reduced from 3195 ± 2359 to 983 ± 972 cGycm(2) (65%, p <0.001) in coronary angiograms and from 7123 ± 4551 to 2431 ± 1788 cGycm(2) (69%, p <0.001) in coronary interventions using the new noise reduction technology. Image quality was graded as similar between the evaluated systems (4.0 ± 0.7 vs 4.2 ± 0.6, not significant). In conclusion, a new x-ray technology with image noise reduction algorithm provides a substantial reduction in radiation exposure without the need to prolong the procedure or fluoroscopy time.
本研究旨在通过在常规临床环境中使用图像降噪技术，定量评估冠状动脉造影和血管成形术中辐射剂量的降低情况。收集了2014年10月至2015年4月在具有降噪技术（Allura Clarity IQ）的冠状动脉造影系统上进行的连续605例冠状动脉手术（397例连续冠状动脉造影和208例连续冠状动脉介入治疗）的辐射剂量数据。为作比较，评估了2013年10月至2014年4月在传统冠状动脉造影系统上进行的连续695例冠状动脉手术（435例冠状动脉造影和260例冠状动脉介入治疗）的辐射剂量数据。基于累积剂量面积乘积评估患者的辐射剂量。在两个评估期间，操作人员和操作习惯没有改变。收集患者特征以评估患者组的相似性。对每组30例患者的图像质量进行5级评分。在性别、年龄、体重和透视时间方面，两个评估组之间无显著差异（分别为6.8±6.1分钟和6.9±6.3分钟，无显著差异）。使用新的降噪技术后，冠状动脉造影中的剂量面积乘积从3195±2359降至983±972 cGycm²（降低65%，p<0.001），冠状动脉介入治疗中的剂量面积乘积从7123±4551降至2431±1788 cGycm²（降低69%，p<0.001）。评估系统之间的图像质量分级相似（分别为4.0±0.7和4.2±0.6，无显著差异）。总之，一种具有图像降噪算法的新型X射线技术可大幅降低辐射暴露，且无需延长手术或透视时间。
