在复杂的穿皮冠状动脉干预中暴露于电离辐射:在导管实验室定义局部诊断参考水平
Hugo Costa1, Miguel Espírito-Santo1, João Bispo1
1Cardiology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal.
本研究确定了葡萄牙复杂的穿皮冠状动脉干预 (PCI) 的辐射诊断参考水平 (DRL). 它设定了可实现的剂量 (ADs),以指导干预心脏病学中的辐射剂量减少.
科学领域:
- 干预心脏病学 干预心脏病学
- 医学物理 医学物理
- 辐射安全 辐射安全
背景情况:
- 干预心脏病学 (IC) 中对电离辐射 (IR) 的担忧越来越大.
- 葡萄牙导管实验室对国家和地方辐射诊断参考水平 (DRL) 的数据有限.
- 需要在复杂的皮肤穿透冠状动脉干预 (PCI) 期间评估IR剂量暴露.
研究的目的:
- 在复杂的PCI程序中评估IR剂量暴露.
- 在葡萄牙的导管实验室中为IR剂量建立DRL.
- 为未来的辐射剂量减少定义可实现剂量 (ADs).
主要方法:
- 复杂PCI (CTO或左主冠状动脉治疗) 患者的回顾性队列研究 (2019-2020).
- DRLs被定义为中位空气克尔马面积 (PKA) 和累积空气克尔马面积 (Ka,r) 的75百分位数.
- 在研究剂量分布的第50个百分点设置的ADs;多变量分析确定了辐射剂量的预测因素.
主要成果:
- 包括242名患者;60.3%接受了CTO手术.
- 在Ka,r = 3012mGy和PKA = 162 Gy cm2为复杂的PCI而建立的DLR.
- ADs设置为Ka,r=1917mGy和PKA=101 Gy cm2 . 在此情况下,我们可以设置Ka,r=1917mGy和PKA=101 Gy cm2. 预测Ka,r的因素包括PKA,光镜时间和PCI时间.
结论:
- 本研究报告了葡萄牙复杂PCI的IR剂量结果.
- 对于Ka,r (3012 mGy) 和PKA (162 Gy cm2) 的确定的DLR.
- 对于Ka,r (1917mGy) 和PKA (101 Gy cm2) 的定义了ADs,以便在未来优化剂量.
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