Department of Clinical Radiology, Tottori University Hospital, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
Department of Quantum Medical Technology, Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan.
Radiol Phys Technol. 2021 Mar;14(1):34-40. doi: 10.1007/s12194-020-00599-8. Epub 2021 Jan 5.
This study aimed to evaluate the relationship between the peak skin dose (PSD) associated with radiation skin injury and the fluoroscopic pulse rate or target vessel during percutaneous coronary intervention (PCI) procedures. We consecutively included 213 patients who underwent PCI procedures. The fluoroscopic time (FT), total number of cine frames, reference air kerma (RAK), and PSD were compared between the two types of fluoroscopic pulse rates (10 and 7.5 pulses/s) and among target vessels. The total number of X-ray tube angulations for each target vessel was also investigated. The median FT was 21.5 min in the 10 pulses/s group and 19.4 min in the 7.5 pulses/s group (p = 0.068, Wilcoxon rank sum test). The median PSD in the 10 pulses/s group was 749 mGy, which was significantly higher than that in the 7.5 pulses/s group (549 mGy) (p < 0.001). The median RAK in the right coronary artery (RCA) was equivalent to that in the left anterior descending artery. However, among the target vessels, the median PSD tended to be the highest in the RCA. There was a difference in the X-ray tube angulation used depending on the target vessel. PCI in the RCA used the left anterior oblique angle more frequently than PCI in the other vessels and tended to use only one angulation. The calculated PSD was related to the target vessel of the PCI procedure, and it was also closely related to the X-ray tube angulation.
本研究旨在评估与经皮冠状动脉介入治疗（PCI）过程中放射性皮肤损伤相关的峰值皮肤剂量（PSD）与透视脉冲率或靶血管之间的关系。我们连续纳入了 213 名接受 PCI 治疗的患者。比较了两种透视脉冲率（10 脉冲/秒和 7.5 脉冲/秒）和靶血管之间的透视时间（FT）、总电影帧数、参考空气比释动能（RAK）和 PSD。还研究了每个靶血管的 X 射线管角度总数。10 脉冲/秒组的中位 FT 为 21.5 分钟，7.5 脉冲/秒组为 19.4 分钟（p=0.068，Wilcoxon 秩和检验）。10 脉冲/秒组的中位 PSD 为 749mGy，明显高于 7.5 脉冲/秒组（549mGy）（p<0.001）。右冠状动脉（RCA）的中位 RAK 与左前降支相等。然而，在靶血管中，RCA 的 PSD 中位数倾向于最高。根据靶血管的不同，X 射线管角度也不同。RCA 的 PCI 比其他血管更频繁地使用前斜左角，并且倾向于仅使用一个角度。计算出的 PSD 与 PCI 手术的靶血管有关，也与 X 射线管角度密切相关。
