Schernthaner Ruediger E, Haroun Reham R, Nguyen Sonny, Duran Rafael, Sohn Jae Ho, Sahu Sonia, Chapiro Julius, Zhao Yan, Radaelli Alessandro, van der Bom Imramsjah M, Mauti Maria, Hong Kelvin, Geschwind Jean-François H, Lin MingDe
Section of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 330 Cedar Street, TE 2-230, New Haven, CT, 06520, USA.
Cardiovasc Intervent Radiol. 2018 Mar;41(3):502-508. doi: 10.1007/s00270-017-1821-z. Epub 2017 Oct 31.
To compare image quality and radiation exposure between a new angiographic imaging system and the preceding generation system during uterine artery embolization (UAE).
In this retrospective, IRB-approved two-arm study, 54 patients with symptomatic uterine fibroids were treated with UAE on two different angiographic imaging systems. The new system includes optimized acquisition parameters and real-time image processing algorithms. Air kerma (AK), dose area product (DAP) and acquisition time for digital fluoroscopy (DF) and digital subtraction angiography (DSA) were recorded. Body mass index was noted as well. DF image quality was assessed objectively by image noise measurements. DSA image quality was rated by two blinded, independent readers on a four-rank scale. Statistical differences were assessed with unpaired t tests and Wilcoxon rank-sum tests.
There was no significant difference between the patients treated on the new (n = 36) and the old system (n = 18) regarding age (p = 0.10), BMI (p = 0.18), DF time (p = 0.35) and DSA time (p = 0.17). The new system significantly reduced the cumulative AK and DAP by 64 and 72%, respectively (median 0.58 Gy and 145.9 Gycm vs. 1.62 Gy and 526.8 Gycm, p < 0.01 for both). Specifically, DAP for DF and DSA decreased by 59% (75.3 vs. 181.9 Gycm, p < 0.01) and 78% (67.6 vs. 312.2 Gycm, p < 0.01), respectively. The new system achieved a significant decrease in DF image noise (p < 0.01) and a significantly better DSA image quality (p < 0.01).
The new angiographic imaging system significantly improved image quality and reduced radiation exposure during UAE procedures.
比较新型血管造影成像系统与上一代系统在子宫动脉栓塞术（UAE）期间的图像质量和辐射暴露情况。
在这项经机构审查委员会（IRB）批准的回顾性双臂研究中，54例有症状子宫肌瘤患者在两种不同的血管造影成像系统上接受了UAE治疗。新系统包括优化的采集参数和实时图像处理算法。记录了空气比释动能（AK）、剂量面积乘积（DAP）以及数字荧光透视（DF）和数字减影血管造影（DSA）的采集时间。还记录了体重指数。通过图像噪声测量客观评估DF图像质量。由两名盲法、独立的阅片者对DSA图像质量进行四级评分。采用非配对t检验和Wilcoxon秩和检验评估统计学差异。
在接受新系统治疗的患者（n = 36）和旧系统治疗的患者（n = 18）之间，年龄（p = 0.10）、体重指数（p = 0.18）、DF时间（p = 0.35）和DSA时间（p = 0.17）方面无显著差异。新系统使累积AK和DAP分别显著降低了64%和72%（中位数分别为0.58 Gy和145.9 Gy·cm，而旧系统为1.62 Gy和526.8 Gy·cm，两者p均<0.01）。具体而言，DF和DSA的DAP分别降低了59%（75.3 vs. 181.9 Gy·cm，p < 0.01）和78%（67.6 vs. 312.2 Gy·cm，p < 0.01）。新系统使DF图像噪声显著降低（p < 0.01），DSA图像质量显著提高（p < 0.01）。
新型血管造影成像系统在UAE手术期间显著提高了图像质量并减少了辐射暴露。
