應用不同攝影技術在心導管透視攝影輻射劑量抑低之研究

The Application of Different Angiography Technique for Radiation Dose Reduction

唐國庭(Kuo-Ting Tang) ； 陳志成(Zhih-Cherng Chen) ； 丁健益(Chien-Yi Ting)

《中華放射線技術學雜誌》 41卷1期 (2017/03) Pp. 5-10

摘要

心導管冠狀動脈造影是診斷與治療冠狀動脈疾病重要的方法之一，然而在治療血管阻塞時，一般需要以血管連續攝影定位，其產生的潛在輻射風險是必須注意的，本實驗目的是比較傳統連續攝影及透視儲存技術，對病人及操作人員的劑量差異。本研究方法納入條件為病人接受經橈動脈心導管診斷，排除條件：(1)為病人由急診入院病人被診斷為急性冠心症或急性心肌梗塞，(2)懷孕或哺乳女性，(3)慢性腎臟病患。病患被隨機分配至透視儲存紀錄組或連續血管攝影組各30 組。連續血管攝影組患者採用常規血管攝影，透視儲存紀錄組則於透視後進行回溯性紀錄進行儲存，只有當操作醫師覺得需要更好的解析度時，才會進行以連續血管攝影重複攝影。過程中利用光激發光劑量計測量表面皮膚吸收劑量。結果顯示，在病人的表面皮膚之吸收劑量可從連續血管攝影組65.57±5.37 mGy 降至透視儲存紀錄組3.13±0.25 mGy (p＜0.001)，操作人員的皮膚吸收劑量從連續血管攝影組0.6519±0.0016 μGy，降至透視儲存紀錄組0.0916±0.0015 μGy(p＜0.001)。所以，在冠狀動脈血管造影中選擇使用透視儲存紀錄，將可有效的減少患者及操作人員之表面皮膚劑量。

關鍵字

冠狀動脈造影 ； 透視儲存模式 ； 光激發光劑量計 ； 連續血管攝影

並列摘要

Coronary angiogram is an imperative tool for diagnosis of coronary artery diseases. Cine-angiography is the common method and the potential risk of radiation exposure for both the patients and the operators should be noticed. In this study, the absorbed radiation dose in stored-fluorography mode was compared with cine-angiography mode by using optically simulated luminescent dosimeters to detect radiation dose. Patients received coronary angiogram via radial artery approach were randomized into the stored-fluorography group (N=30) or the cine-angiography group (N=30). The excluded criteria were: patients diagnosed by emergency room patients admitted for acute coronary syndrome (ACS) or acute myocardial infarction (AMI), women at pregnancy or on breast feeding, and patients with chronic kidney diseases. During the coronary angiogram, absorbed dose of the patients and the operator radiation exposure was measured with optically simulated luminescent dosimeter (OSLD). The skin absorbed dose of the patients in the stored-fluorography group (3.13±0.25 mGy) was apparently lower than that in the cine-angiography group (65.57±5.37 mGy; p＜0.001). For the operator skin, a statistical difference (p＜0.001) was also found between the stored-fluorography group (0.0916±0.0015 μGy) and the cine-angiography (0.6519±0.0016 μGy). Compared with traditional cine-angiography mode, the stored-fluorography mode can apparently reduce radiation exposure of the patients and the operator in coronary angiogram.

並列關鍵字

coronary angiogram ； stored-fluorography mode ； optically simulated luminescent dosimeter (OSLD) ； cine-angiography