在介入心脏病学手术期间使用辐射变色薄膜评估患者的皮肤峰值剂量：常规经验反馈
Assessment of Patient's Peak Skin Dose Using Gafchromic Films During Interventional Cardiology Procedures: Routine Experience Feedback.
作者信息
Greffier J, Moliner G, Pereira F, Cornillet L, Ledermann B, Schmutz L, Lomma M, Cayla G, Beregi J P
机构信息
Department of Radiology, Nîmes University Hospital, Medical Imaging Group Nîmes, EA 2415, Bd Prof Robert Debré, 30029 Nîmes Cedex, France.
Department of Cardiology, Nîmes University Hospital, Bd Prof Robert Debré, 30029 Nîmes Cedex, France.
出版信息
Radiat Prot Dosimetry. 2017 Apr 28;174(3):395-405. doi: 10.1093/rpd/ncw191.
To assess the interest of Gafchromic films in detection of patient's peak skin dose (PSD) in interventional cardiology. A prospective study of 112 patients was conducted (July-December 2015). Three diagnostic and therapeutic procedures were evaluated: coronary angiography (CA), coronary angiography and coronary angioplasty for one or two vessels disease (CA-PTCA) and coronary angioplasty of complex chronic total occlusion (CTO). Dosimetric indicators (DIs) were collected and PSD were measured with Gafchromic films. Dose distribution was evaluated within 10 'Thorax Body-zone' defined by the system. Correlations between PSD and DI or dose distribution were computed. Delivered dose increased in complex procedures. The PSD were 0.121 ± 0.063 Gy for CA, 0.256 ± 0.142 Gy for CA-PTCA and 1.116 ± 0.721 Gy for CTO. High correlations were observed for PSD and DI as well for dose distribution within the 'Thorax Body-zone'. Film dosimetry is suggested for CTO procedures since the threshold of 2 Gy for skin injuries is likely to be exceeded.
评估放射变色薄膜在检测介入心脏病学中患者皮肤峰值剂量（PSD）方面的应用价值。对112例患者进行了一项前瞻性研究（2015年7月至12月）。评估了三种诊断和治疗程序：冠状动脉造影（CA）、针对单支或双支血管病变的冠状动脉造影及冠状动脉血管成形术（CA-PTCA）以及复杂慢性完全闭塞病变（CTO）的冠状动脉血管成形术。收集剂量学指标（DIs），并用放射变色薄膜测量PSD。在该系统定义的10个“胸部体区”内评估剂量分布。计算PSD与DI或剂量分布之间的相关性。复杂手术中的输送剂量增加。CA的PSD为0.121±0.063 Gy，CA-PTCA为0.256±0.142 Gy，CTO为1.116±0.721 Gy。在“胸部体区”内，PSD与DI以及剂量分布之间均观察到高度相关性。由于CTO手术可能超过皮肤损伤的2 Gy阈值，因此建议对CTO手术采用薄膜剂量测定法。
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