在接受诊断性有创冠状动脉造影的患者中使用新型荧光透视系统降低辐射剂量

Radiation Dose Reduction Using a Novel Fluoroscopy System in Patients Undergoing Diagnostic Invasive Coronary Angiography.

作者信息

Kraemer Bjoern F, Tesche Christian, Hapfelmeier Alexander, Finsterer Sebastian, Ebersberger Ullrich, Schlüter Mathis, Ziegler Martin, Martens Eimo, Laugwitz Karl-Ludwig, Schmidt Martin

机构信息

Department of Cardiology, Kreisklinik Ebersberg, Ebersberg.

Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen.

出版信息

J Thorac Imaging. 2021 Jan;36(1):52-56. doi: 10.1097/RTI.0000000000000510.

DOI:10.1097/RTI.0000000000000510

PMID:32251233

Abstract

BACKGROUND

Invasive coronary angiography (ICA) still causes a significant amount of radiation exposure for patients and operators. In February 2017, the Azurion system was introduced, a new-generation fluoroscopy image acquisition and processing system. Radiation exposure in patients undergoing ICA was assessed comparing the novel Azurion 7 F12 angiography system to its predecessor Allura Xper in a randomized manner.

METHODS

Radiation exposure was prospectively analyzed in 238 patients undergoing diagnostic ICA. Patients were randomly assigned to the novel Azurion system (119 patients) or its predecessor Allura Xper system (119 patients). In each patient, 8 predefined standard projections (5 left coronary artery, 3 right coronary artery) were performed. Image quality was quantified by grading of the images on the basis of a 5-point grading system.

RESULTS

Radiation dose area product was significantly lower in the Azurion group 109 (interquartile range [IQR 75-176] cGy cm) compared with the Allura Xper group 208 [IQR 134-301] cGy cm (P<0.001). Body mass index (26.6 [IQR 23.9-29.7] kg/m vs. 26.2 [IQR 24.2-29.4] kg/m; P=0.607), body surface area (1.96 [IQR 1.81-2.11] m vs. 1.90 [IQR 1.77-20.4] m; P=0.092), and procedure duration (1.5 [IQR 1.2-2.3] min vs. 1.6 [IQR 1.2-2.5] min; P=0.419) were similar in both groups. Images from the Azurion system were at least of equal quality compared with Allura Xper (image quality grade 4.82±0.45 vs. 4.75±0.52, P=0.43).

CONCLUSION

Use of the novel Azurion 7 F12 angiography system resulted in a significant reduction of dose area product in patients undergoing diagnostic ICA by 56%.

摘要

背景

侵入性冠状动脉造影术（ICA）仍会给患者和操作人员带来大量辐射暴露。2017年2月，引入了Azurion系统，这是一种新一代荧光透视图像采集和处理系统。通过将新型Azurion 7 F12血管造影系统与其前身Allura Xper以随机方式进行比较，评估了接受ICA的患者的辐射暴露情况。

方法

对238例接受诊断性ICA的患者的辐射暴露情况进行前瞻性分析。患者被随机分配到新型Azurion系统组（119例患者）或其前身Allura Xper系统组（119例患者）。对每位患者进行8个预定义的标准投影（5个左冠状动脉投影，3个右冠状动脉投影）。根据5分制对图像进行分级，以量化图像质量。

结果

Azurion组的辐射剂量面积乘积显著低于Allura Xper组，分别为109（四分位间距[IQR 75 - 176]cGy·cm）和208[IQR 134 - 301]cGy·cm（P<0.001）。两组的体重指数（26.6[IQR 23.9 - 29.7]kg/m²对26.2[IQR 24.2 - 29.4]kg/m²；P = 0.607）、体表面积（1.96[IQR 1.81 - 2.11]m²对1.90[IQR 1.77 - 2.04]m²；P = 0.092）和手术持续时间（1.5[IQR 1.2 - 2.3]分钟对1.6[IQR 1.2 - 2.5]分钟；P = 0.419）相似。与Allura Xper相比，Azurion系统的图像质量至少相当（图像质量等级4.82±0.45对4.75±0.52，P = 0.43）。