Ichimoto Eiji, Kadohira Tadayuki, Nakayama Takashi, De Gregorio Joseph
Department of Invasive Cardiology, Englewood Hospital and Medical Center, Englewood, New Jersey.
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Catheter Cardiovasc Interv. 2018 Mar 1;91(4):717-722. doi: 10.1002/ccd.27150. Epub 2017 May 30.
This study assessed that the use of real-time monitoring and visualization of peak skin dose could reduce radiation dose during coronary angiography (CAG) and percutaneous coronary intervention (PCI).
Exposure to ionizing radiation has dose related effects including skin damage. Reducing the radiation exposure is important during CAG and PCI. The skin dose-tracking system (DTS) has a real-time monitor of radiation peak skin dose.
A total of 323 consecutive patients who underwent CAG and PCI between September 2014 and June 2015 were enrolled. Patients were classified into with DTS group (CAG alone in 104 and PCI in 57 patients) or without DTS group (CAG alone in 106 and PCI in 56 patients).
There was no significant difference in reference air kerma between CAG alone with and without DTS groups. Reference air kerma with DTS group during PCI was lower than without DTS group (204.6 ± 141.1 mGy vs. 294.2 ± 237.4 mGy, P = 0.016). Moreover, kerma area product (17.8 ± 13.0 Gycm vs. 25.2 ± 19.3 Gycm , P = 0.019) and number of cine runs (12.8 ± 5.0 vs. 15.5 ± 6.5, P = 0.013) with DTS group were lower than without DTS group. Multiple regression analysis showed increased reference air kerma was associated with male gender, body mass index and type B2/C lesion. Conversely, DTS correlated with decreased reference air kerma.
The use of DTS could reduce radiation dose during PCI. Real-time radiation monitoring and visualization of peak skin dose was effective for the patients with PCI.
本研究评估了使用实时监测和可视化峰值皮肤剂量能否在冠状动脉造影（CAG）和经皮冠状动脉介入治疗（PCI）期间降低辐射剂量。
暴露于电离辐射会产生与剂量相关的影响，包括皮肤损伤。在CAG和PCI期间减少辐射暴露很重要。皮肤剂量跟踪系统（DTS）可实时监测辐射峰值皮肤剂量。
纳入2014年9月至2015年6月期间连续接受CAG和PCI的323例患者。患者分为使用DTS组（单纯CAG 104例，PCI 57例）和未使用DTS组（单纯CAG 106例，PCI 56例）。
单纯CAG时，使用和未使用DTS组之间的参考空气比释动能无显著差异。PCI期间，使用DTS组的参考空气比释动能低于未使用DTS组（204.6±141.1 mGy对294.2±237.4 mGy，P = 0.016）。此外，使用DTS组的比释动能面积乘积（17.8±13.0 Gycm对25.2±19.3 Gycm，P = 0.019）和电影拍摄次数（12.8±5.0对15.5±6.5，P = 0.013）低于未使用DTS组。多元回归分析显示，参考空气比释动能增加与男性、体重指数和B2/C型病变有关。相反，DTS与参考空气比释动能降低相关。
使用DTS可降低PCI期间的辐射剂量。实时辐射监测和峰值皮肤剂量可视化对PCI患者有效。
