Safari Mohammad Javad, Wong Jeannie Hsiu Ding, Jong Wei Loong, Thorpe Nathan, Cutajar Dean, Rosenfeld Anatoly, Ng Kwan Hoong
Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; University of Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; University of Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Phys Med. 2017 Mar;35:66-72. doi: 10.1016/j.ejmp.2017.02.002. Epub 2017 Feb 27.
The purpose of this study was to investigate the effects of routine exposure parameters on patient's dose during neuro-interventional radiology procedures.
We scrutinized the routine radiological exposure parameters during 58 clinical neuro-interventional procedures such as, exposure direction, magnification, frame rate, and distance between image receptor to patient's body and evaluate their effects on patient's dose using an anthropomorphic phantom. Radiation dose received by the occipital region, ears and eyes of the phantom were measured using MOSkin detectors.
DSA imaging technique is a major contributor to patient's dose (80.9%) even though they are used sparingly (5.3% of total frame number). The occipital region of the brain received high dose largely from the frontal tube constantly placed under couch (73.7% of the total KAP). When rotating the frontal tube away from under the couch, the radiation dose to the occipital reduced by 40%. The use of magnification modes could increase radiation dose by 94%. Changing the image receptor to the phantom surface distance from 10 to 40cm doubled the radiation dose received by the patient's skin at the occipital region.
Our findings provided important insights into the contribution of selected fluoroscopic exposure parameters and their impact on patient's dose during neuro-interventional radiology procedures. This study showed that the DSA imaging technique contributed to the highest patient's dose and judicial use of exposure parameters might assist interventional radiologists in effective skin and eye lens dose reduction for patients undergoing neuro-interventional procedures.
本研究旨在探讨神经介入放射学程序中常规曝光参数对患者剂量的影响。
我们仔细研究了58例临床神经介入程序中的常规放射学曝光参数，如曝光方向、放大倍数、帧率以及影像接收器与患者身体之间的距离，并使用人体模型评估它们对患者剂量的影响。使用MOSkin探测器测量模型枕部、耳部和眼部所接受的辐射剂量。
数字减影血管造影（DSA）成像技术是患者剂量的主要贡献因素（80.9%），尽管其使用频率较低（占总帧数的5.3%）。大脑枕部区域接受的高剂量主要来自始终置于检查床下的前部球管（占总空气比释动能积的73.7%）。将前部球管从检查床下旋转开时，枕部的辐射剂量降低了40%。使用放大模式可使辐射剂量增加94%。将影像接收器与模型表面的距离从10厘米改变为40厘米，会使患者枕部皮肤接受的辐射剂量增加一倍。
我们的研究结果为神经介入放射学程序中选定的透视曝光参数的贡献及其对患者剂量的影响提供了重要见解。本研究表明，DSA成像技术导致患者接受的剂量最高，合理使用曝光参数可能有助于介入放射科医生有效降低接受神经介入程序患者的皮肤和晶状体剂量。
