Panick Catherine, Wunderle Kevin, Sands Mark, Martin Charles
Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH, 44106, USA.
Diagnostic Radiology, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Cardiovasc Intervent Radiol. 2018 Dec;41(12):1925-1934. doi: 10.1007/s00270-018-2052-7. Epub 2018 Aug 21.
We sought to evaluate patient radiation exposure during complex liver interventional procedures performed with newer angiography equipment.
We conducted a retrospective study of transjugular intrahepatic portosystemic shunt (TIPS) creations and liver tumor embolizations performed in our new angiography suite (Discovery IGS740, GE Healthcare). T tests were used to compare air kerma-area product (P) and reference plane air kerma (K) in the new room versus data from historical rooms and previous studies (including the RAD IR study). Results were expressed as medians [interquartile ranges (Q1, Q3)].
From February 2015 to June 2016, 134 complex liver interventional procedures were performed in the new room, including 14 TIPS creations, 60 hepatic tumor arterial embolizations (HAEs), 26 Y90 mappings (Y90m), and 34 Y90 radioembolizations (Y90). K (Gy) values were as follows: TIPS, 0.65 (0.24, 1.15); HAE, 0.89 (0.49, 1.49); Y90m, 0.54 (0.38, 0.94); Y90, 0.46 (0.21, 1.06). P (Gy·cm) values were as follows: TIPS, 148.2 (66.7, 326.5); HAE, 142.6 (88, 217.8); Y90m, 148.3 (98.2, 247); Y90, 90.8 (43.9, 161.5). K and P were lower in the new room than in historical rooms [K and P reductions: TIPS, 58 and 49%; HAE, 31 and 39%; Y90m, 58 and 52%; Y90, 49 and 56% (p < 0.05)] and versus the RAD IR study [K and P reductions: TIPS, 64 and 43%; HAE, 26 and 40% (p < 0.05)].
Using the latest technology and image processing tools enables significant reduction in radiation exposure during complex liver interventional procedures.
我们旨在评估使用新型血管造影设备进行复杂肝脏介入手术时患者的辐射暴露情况。
我们对在我们新的血管造影套件（GE医疗的Discovery IGS740）中进行的经颈静脉肝内门体分流术（TIPS）创建和肝肿瘤栓塞术进行了回顾性研究。采用T检验比较新房间中的空气比释动能面积乘积（P）和参考平面空气比释动能（K）与历史房间的数据以及先前研究（包括RAD IR研究）的数据。结果以中位数[四分位间距（Q1，Q3）]表示。
2015年2月至2016年6月，新房间内进行了134例复杂肝脏介入手术，包括14例TIPS创建、60例肝肿瘤动脉栓塞术（HAE）、26例钇90映射（Y90m）和34例钇90放射栓塞术（Y90）。K（Gy）值如下：TIPS为0.65（0.24，1.15）；HAE为0.89（0.49，1.49）；Y90m为0.54（0.38，0.94）；Y90为0.46（0.21，1.06）。P（Gy·cm）值如下：TIPS为148.2（66.7，326.5）；HAE为142.6（88，217.8）；Y90m为148.3（98.2，247）；Y90为90.8（43.9，161.5）。新房间中的K和P低于历史房间[K和P降低值：TIPS分别为58%和49%；HAE分别为31%和39%；Y90m分别为58%和52%；Y90分别为49%和56%（p < 0.05）]，并且与RAD IR研究相比[K和P降低值：TIPS分别为64%和43%；HAE分别为26%和40%（p < 0.05）]。
使用最新技术和图像处理工具可显著降低复杂肝脏介入手术期间的辐射暴露。
