Uniyal Satish C, Chaturvedi Vineet, Sharma Sunil D, Rawat Anurag
Department of Radiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun 248016, India.
Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, Anushaktinagar, Mumbai 400094, India.
Radiat Prot Dosimetry. 2017 Jun 15;175(2):201-208. doi: 10.1093/rpd/ncw286.
Cardiac interventions often result in high radiation dose to patient's skin, so a reliable indicator in terms of a commonly used dose descriptor is required to monitor skin exposures. In the present study, Gafchromic XR-RV3 film was used to measure the peak skin dose (PSD) during 40 coronary angiography (CA) and 50 percutaneous transluminal coronary angioplasty (PTCA) procedures. Corresponding values of kerma-area product (PKA), fluoroscopy time (FT) and reference air-kerma (Ka,r) were recorded and correlated with PSD. Doses to patient's eyes and thyroid were also measured by using thermoluminescent dosimeters (TLDs) during PTCA procedures. The average dose to thyroid was about six times higher than the average dose to eyes. The mean values of PSD, PKA and FT were 1140 mGy, 97 Gy cm2 and 15.7 min for PTCA and 290 mGy, 21.1 Gy cm2 and 2.4 min for CA procedures, respectively. One in seven patients of PTCA procedure received PSD >2 Gy. With respect to FT, PKA may be used as a better predictor of skin exposures because the correlation of PSD with PKA was found better than with FT for both CA and PTCA procedures.
心脏介入治疗常常会给患者皮肤带来高辐射剂量，因此需要一个基于常用剂量描述符的可靠指标来监测皮肤暴露情况。在本研究中，使用Gafchromic XR-RV3胶片测量了40例冠状动脉造影（CA）和50例经皮腔内冠状动脉成形术（PTCA）过程中的皮肤峰值剂量（PSD）。记录了比释动能面积乘积（PKA）、透视时间（FT）和参考空气比释动能（Ka,r）的相应值，并将其与PSD进行关联。在PTCA过程中，还使用热释光剂量计（TLD）测量了患者眼睛和甲状腺所接受的剂量。甲状腺的平均剂量约为眼睛平均剂量的六倍。PTCA和CA过程中，PSD、PKA和FT的平均值分别为1140 mGy、97 Gy cm²和15.7分钟，以及290 mGy、21.1 Gy cm²和2.4分钟。PTCA过程中，七分之一的患者接受的PSD >2 Gy。就FT而言，PKA可能是皮肤暴露情况更好的预测指标，因为在CA和PTCA过程中，均发现PSD与PKA的相关性优于与FT的相关性。
