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神经介入放射学手术中的患者辐射剂量:三级医疗中心的经验

Patient Radiation Dose in Neurointerventional Radiologic Procedure: A Tertiary Care Experience.

作者信息

Riabroi Kittipong, Khanungwanitkul Khanin, Wattanapongpitak Prasert, Krisanachinda Anchali, Hongsakul Keerati

机构信息

Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.

Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

Neurointervention. 2018 Sep;13(2):110-116. doi: 10.5469/neuroint.2018.00983. Epub 2018 Aug 31.

Abstract

PURPOSE

Neurointerventional radiology procedures often require a long time to perform. Patient radiation dose is an important issue due to the hazards of ionizing radiation. The objective of this study was to measure the peak skin dose (PSD) and effective dose to estimate the deterministic and stochastic effects of a therapeutic interventional neuroradiologic procedure.

MATERIALS AND METHODS

The cumulative dose (CD) and dose area product (DAP) were automatically recorded by a fluoroscopic machine and collected prospectively between April and November 2015. The study included 54 patients who underwent therapeutic neurointerventional radiology procedures. The CD of each patient was used to estimate the peak skin dose and the DAP was also calculated to estimate the effective dose.

RESULTS

The average estimated peak skin dose was 1,009.68 mGy. Two patients received radiation doses of more than 2 Gy, which is the threshold that may cause skin complications and radiation-induced cataract. The average effective dose was 35.32 mSv. The majority of patients in this study (85.2%) who underwent therapeutic neurointerventional radiologic procedures received effective doses greater than 20 mSv.

CONCLUSION

Not all therapeutic neurointerventional radiology procedures are safe from deterministic complications. A small number of patients received doses above the threshold for skin complications and radiation induced cataract. In terms of stochastic complications, most neurointerventional radiology procedures in this study were quite safe in terms of radiation-induced cancer.

摘要

目的

神经介入放射学手术通常需要较长时间来完成。由于电离辐射的危害,患者的辐射剂量是一个重要问题。本研究的目的是测量皮肤峰值剂量(PSD)和有效剂量,以评估治疗性介入神经放射学手术的确定性和随机性效应。

材料与方法

透视机自动记录累积剂量(CD)和剂量面积乘积(DAP),并于2015年4月至11月前瞻性收集数据。该研究纳入了54例行治疗性神经介入放射学手术的患者。用每位患者的CD来估算皮肤峰值剂量,并计算DAP以估算有效剂量。

结果

平均估算皮肤峰值剂量为1009.68 mGy。两名患者接受的辐射剂量超过2 Gy,这是可能导致皮肤并发症和辐射性白内障的阈值。平均有效剂量为35.32 mSv。本研究中大多数接受治疗性神经介入放射学手术的患者(85.2%)接受的有效剂量大于20 mSv。

结论

并非所有治疗性神经介入放射学手术都能避免确定性并发症。少数患者接受的剂量高于皮肤并发症和辐射性白内障的阈值。就随机性并发症而言,本研究中的大多数神经介入放射学手术在辐射诱发癌症方面相当安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddf9/6132035/cfba63e8bee5/neuroint-2018-00983f1.jpg

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