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[降低透视脉冲率对经皮冠状动脉介入治疗中器械可视性和辐射剂量的影响]

[Effect of Reducing Fluoroscopy Pulse Rates on Visibility of Devices and Radiation Dose in Percutaneous Coronary Intervention].

作者信息

Yoshida Masato, Niwa Masayoshi, Takahashi Yasukata, Kuratani Yosuke

机构信息

Department of Radiology, Yokkaichi Municipal Hospital.

出版信息

Nihon Hoshasen Gijutsu Gakkai Zasshi. 2024 May 20;80(5):519-529. doi: 10.6009/jjrt.2024-1396. Epub 2024 Apr 4.

DOI:10.6009/jjrt.2024-1396
PMID:38569842
Abstract

The goal of our study was to clarify the effect of low pulse rate fluoroscopy applying in percutaneous coronary intervention (PCI) on devices' visibility and radiation dose. Four types of fluoroscopy conditions combined with two pulse rates (7.5 and 15 pulses/s) and two types of adaptive temporal filters (ATFs) (weak and strong) were used. Samples for visibility evaluation were acquired with moving phantom and devices such as stent, balloon, and guidewire. Trailing artifacts and the visibility of stent were evaluated by Scheffe's method of paired comparisons. Incident air kerma (K) and kerma area product (P) in the clinic were obtained under two fluoroscopic pulse rate conditions (7.5 and 15 pulses/s). As a result, in 7.5 pulses/s fluoroscopy, trailing artifacts were decreased by using weak ATF with the median value of P and K reduced by about 50%, but stent visibility was decreased compared to 15 pulses/s. Therefore, a combination of 7.5 pulses/s fluoroscopy and suitable ATF can bring dose reduction with avoiding trailing artifacts, but dose per pulse should be adjusted to maintain the stent visibility.

摘要

我们研究的目的是阐明低脉冲率荧光透视应用于经皮冠状动脉介入治疗(PCI)时对器械可视性和辐射剂量的影响。使用了四种荧光透视条件,结合两种脉冲率(7.5和15脉冲/秒)以及两种类型的自适应时间滤波器(ATF)(弱和强)。使用移动体模和诸如支架、球囊和导丝等器械获取用于可视性评估的样本。通过谢费尔配对比较法评估拖尾伪影和支架的可视性。在两种荧光透视脉冲率条件(7.5和15脉冲/秒)下获取临床中的空气比释动能(K)和比释动能面积乘积(P)。结果,在7.5脉冲/秒的荧光透视中,使用弱ATF可减少拖尾伪影,P和K的中值降低约50%,但与15脉冲/秒相比,支架可视性降低。因此,7.5脉冲/秒的荧光透视与合适的ATF相结合可在避免拖尾伪影的同时降低剂量,但应调整每脉冲剂量以维持支架可视性。

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