经腹超声引导下经颈静脉门静脉穿刺在经颈静脉肝内门体分流术形成中的辐射剂量应用。
Use of transabdominal ultrasound-guided transjugular portal vein puncture on radiation dose in transjugular intrahepatic portosystemic shunt formation.
作者信息
Tavare Aniket N, Wigham Andrew, Hadjivassilou Anastasia, Alvi Abdulrahman, Papadopoulou Anthie, Goode Antony, Woodward Nick, Patch David, Yu Dominic, Davies Neil
机构信息
Departments of Radiology, Royal Free London NHS Foundation Trust, London, UK.
出版信息
Diagn Interv Radiol. 2017 May-Jun;23(3):206-210. doi: 10.5152/dir.2016.15601.
Abstract
PURPOSE
Transjugular intrahepatic portosystemic shunt (TIPS) creation is used to treat portal hypertension complications. Often the most challenging and time-consuming step in the procedure is the portal vein (PV) puncture. TIPS procedures are associated with prolonged fluoroscopy time and high patient radiation exposures. We measured the impact of transabdominal ultrasound guidance for PV puncture on duration of fluoroscopy time and dose.
METHODS
We retrospectively analyzed the radiation dose for all TIPS performed over a four-year period with transabdominal ultrasound guidance for PV puncture (n=212, with 210 performed successfully and data available for 206); fluoroscopy time, dose area product (DAP) and skin dose were recorded.
RESULTS
Mean fluoroscopy time was 12 min 9 s (SD, ±14 min 38 s), mean DAP was 40.3±73.1 Gy·cm2, and mean skin dose was 404.3±464.8 mGy.
CONCLUSION
Our results demonstrate that ultrasound-guided PV puncture results in low fluoroscopy times and radiation doses, which are markedly lower than the only published dose reference levels.
摘要
目的
经颈静脉肝内门体分流术（TIPS）用于治疗门静脉高压并发症。该手术中最具挑战性且耗时的步骤通常是门静脉（PV）穿刺。TIPS手术与透视时间延长和患者高辐射暴露相关。我们测量了经腹超声引导门静脉穿刺对透视时间和剂量的影响。
方法
我们回顾性分析了在四年期间所有在经腹超声引导门静脉穿刺下进行的TIPS手术的辐射剂量（n = 212，成功进行210例，206例有可用数据）；记录了透视时间、剂量面积乘积（DAP）和皮肤剂量。
结果
平均透视时间为12分9秒（标准差，±14分38秒），平均DAP为40.3±73.1 Gy·cm²，平均皮肤剂量为404.3±464.8 mGy。
结论
我们的结果表明，超声引导门静脉穿刺导致透视时间和辐射剂量较低，明显低于唯一已发表的剂量参考水平。
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