在冠状动脉疾病的全球辐射剂量诊断成像成像
Andrew J Einstein1,2, Michelle C Williams3, Jonathan R Weir-McCall4
1Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.
JAMA
|February 25, 2026
概括
在全球范围内,冠状动脉疾病 (CAD) 诊断成像的辐射剂量因模式和地区而异. 需要努力标准化协议并减少患者的辐射暴露,特别是在低收入国家.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 公共卫生 公共卫生
背景情况:
- 全球冠状动脉疾病 (CAD) 诊断测试的增加.
- 常见的成像方式使患者暴露在电离辐射中.
- 需要评估来自非侵入性CAD测试的全球辐射剂量.
研究的目的:
- 为了检查在全球范围内进行非侵入性CAD诊断测试的患者的辐射剂量.
- 为了确定辐射有效剂量在不同成像方式和地理区域的变化.
- 为了将辐射剂量与既定指南进行比较.
主要方法:
- 在全球范围内,对19302名接受非侵入性CAD成像检查的成年人进行了横截面研究.
- 在2023年底的一周内,从101个国家的742个中心收集的数据.
- 图像处理方式包括SPECT,PET,CACS和CCTA.
主要成果:
- 平均有效剂量因模式而有所不同:CACS (1.2 mSv),PET (2.0 mSv),SPECT (6.5 mSv),CCTA (7.4 mSv). 这两种方法均为有效剂量中位数.
- 观察到显著的区域差异,在某些程序中,拉丁美洲和非洲的剂量最高.
- 低收入国家与高收入国家相比,辐射剂量更高,特别是CCTA.
结论:
- 从CAD诊断测试中患者辐射剂量的显著变化需要改进培训,标准化协议和更新的设备.
- 需要特别注意低收入和中等收入国家的患者以及接受CCTA的患者.
- 有机会提高全球CAD诊断的质量和安全性.
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