脑血管介入造影检查中患者X射线辐射评价与剂量控制方法  

Evaluation of X-ray radiation exposure and controlling dose methods in patients with cerebral vessels interventional angiography procedures

作　　者：朱栋梁[1] 卢建华[1] 陈胜利[1] 陈国东[1] 黄子诚[1] 罗超平[1] 

机构地区：[1]广州市第一人民医院介入放射科,广东广州510180

出　　处：《生物医学工程与临床》2012年第3期246-249,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的研究脑血管介入造影检查中患者所受的X射线辐射,探讨降低辐射剂量的控制方法。方法85例疑诊脑血管病变患者,分2组。A组55例采用机器默认曝光条件,其中男性38例,女性17例,年龄(46.21±16.26)岁。B组30例采用人工设定曝光条件进行剂量控制,其中男性19例,女性11例,年龄(45.62±17.58)岁。采用Siemens Angiostar Plus数字减影血管造影(DSA)机配置的电离室型实时剂量测量系统(diamentor K1 and diamentor ED),回顾性分析设备默认条件下和剂量控制方法后的脑血管介入造影检查患者所受的X射线辐射剂量资料。在DSA机上读取光盘存储的面积剂量乘积(DAP)和入射表面剂量(ESD)数据;分析采用剂量控制方法后对射线剂量的影响。结果A组患者的透视时间为(18.36±13.29)min,摄片(454.31±152.35)帧,总DAP为(14 286.63±5 324.19)cGy.cm2,总ESD为(1 107.25±432.21)mGy,其中透视对总DAP的贡献为(9.04%±6.08%),小于摄片对总DAP的贡献(90.96%±6.08%),透视对总ESD的贡献为(10.68%±7.96%),小于摄片对总ESD的贡献(89.32%±7.96%)。B组患者的每分钟透视剂量、每帧射影剂量、每序列帧数及总的辐射剂量均比A组低,差异有统计学意义(P<0.05)。结论脑血管介入造影检查中,患者受到一次性较大剂量的X射线辐射;造影时适度提高管电压、降低摄片数量和透视时采用低频率脉冲透视,是有效减少患者X射线辐射剂量的控制方法。Objective To evaluate the X-ray radiation of patients and search methods of controlling the radiation dose in cerebral vessels interventional angiography procedures.Methods A total of 85 patients suspected cerebral vascular disease were divided into 2 groups.There were 55 patients in group A,included 38 males and 17 females,aged（46.21 ± 16.26） years old,and the machine default exposure conditions were used.There were 30 patients in group B,included 19 males and 11 females,aged（45.62 ± 17.58） years old,and the exposure conditions was set with manually.With dose measurement system（diamentor K1 and diamentor ED） of Siemens Angiostar Plus digital substraction angiography equipment（DSA）,dose-area product（DAP） and entrance surface dose（ESD） were recorded in data-CD.The radiation dose of 55 patients with DSA default parameter and 30 patients with controlling dose parameter were analyzed.The effect of radiation dose after using methods of controlling dose was studied.Results In group A,the mean fluoroscopy time was（18.36 ± 13.29） minutes,the mean number of angiographic exposure was（454.31 ± 152.35） flames,and the mean of total DAP dose was（14 286.63 ± 5 324.19） cGy·cm2.The contribution of fluoroscopy on total DAP dose（9.04 % ± 6.08 %） was lower than that of angiographic exposure（90.96 % ± 6.08 %）,the contribution of fluoroscopy on total ESD dose（10.68 % ± 7.96 %） was same lower than that of angiographic exposure（89.32 % ± 7.96 %）.Compared the radiation dose of group B,the fluoroscopy dose per minute,angiographic exposure dose per flame,numbers of flames per series and the total radiation dose had decreased,the differences were statistically significant（P 0.05）.Conclusion It is demonstrated that the patients suffer a large mass of X-ray radiation exposure in cerebral vessels interventional angiography procedures.The methods that rising X-ray tube voltage,reducing the numbers of angiographic exposure and fluoroscopy with low frequency pulse,could be used to

关 键 词：X射线辐射 脑血管介入造影检查 剂量控制 

分 类 号：R743[医药卫生—神经病学与精神病学]