심장혈관 조영술과 인터벤션은 현대 성인병의 증가로 급격히 증가하고 있다. 심장혈관 인터벤션은 장시간 동일 부위에 방사선을 조사하는 검사로 방사선으로 인한 피부상해를 일으킬 수 있다. 본 연구에서는 의료기관의 심장혈관 인터벤션의 진단참조준위를 조사하여 환자의 피폭선량을 감소시키는 도구로 사용하고자 한다. 본 연구는 147명의 환자에서 심장혈관 조영술과 인터벤션을 대상으로 누적 투시시간, 누적 투시면적선량, 영상촬영을 위한 면적선량, 누적 면적선량, 공기커마, 동영상 수, 총 영상 수에 대한 정보를 획득하여 진단참조준위를 설정하였다. 심장혈관 조영술의 진단참조준위와 인터벤션의 진단참조준위에 해당하는 면적선량 값은 각각 $44.4 Gy{\cdot}cm2$와 $298.6Gy{\cdot}cm2$로 나타났고 투시시간에 대한 진단참조준위는 각각 191.5 sec와 1935.3 sec로 나타났다. 진단참조준위는 반드시 넘으면 안 되는 값은 아니다. 하지만 진단참조준위를 제정하여 의료 기관에서 사용하고 있는 선량의 참조 값을 설정하고 이를 검토하는 과정은 환자의 불필요한 피폭선량을 감소시키는데 기여할 것이다.
심장혈관 조영술과 인터벤션은 현대 성인병의 증가로 급격히 증가하고 있다. 심장혈관 인터벤션은 장시간 동일 부위에 방사선을 조사하는 검사로 방사선으로 인한 피부상해를 일으킬 수 있다. 본 연구에서는 의료기관의 심장혈관 인터벤션의 진단참조준위를 조사하여 환자의 피폭선량을 감소시키는 도구로 사용하고자 한다. 본 연구는 147명의 환자에서 심장혈관 조영술과 인터벤션을 대상으로 누적 투시시간, 누적 투시면적선량, 영상촬영을 위한 면적선량, 누적 면적선량, 공기커마, 동영상 수, 총 영상 수에 대한 정보를 획득하여 진단참조준위를 설정하였다. 심장혈관 조영술의 진단참조준위와 인터벤션의 진단참조준위에 해당하는 면적선량 값은 각각 $44.4 Gy{\cdot}cm2$와 $298.6Gy{\cdot}cm2$로 나타났고 투시시간에 대한 진단참조준위는 각각 191.5 sec와 1935.3 sec로 나타났다. 진단참조준위는 반드시 넘으면 안 되는 값은 아니다. 하지만 진단참조준위를 제정하여 의료 기관에서 사용하고 있는 선량의 참조 값을 설정하고 이를 검토하는 과정은 환자의 불필요한 피폭선량을 감소시키는데 기여할 것이다.
The use of cardiac angiography (CA) and the interventional procedures is rapidly increasing due to the increase in modern adult diseases. Cardiovascular intervention (CI) is an examination method where radiation is applied to the same area for a long period, and thus may cause skin injury. In this s...
The use of cardiac angiography (CA) and the interventional procedures is rapidly increasing due to the increase in modern adult diseases. Cardiovascular intervention (CI) is an examination method where radiation is applied to the same area for a long period, and thus may cause skin injury. In this study, we investigate the diagnostic reference level (DRL) of the cardiovascular intervention (CI) carried out by medical institutions and use it as a tool to reduce patient exposure dose. In this study, the DRL was set by acquiring information about the cumulative fluoroscopy time, cumulative fluoroscopy dose-area product (DAP), radiography DAP, cumulative DAP, air kerma, number of video clips, and the total number of images from the cardiac angiography and interventional procedures performed on 147 patients. The DAPs corresponding to the DRL of cardiac angiography(CA) and that of the interventional procedures were shown to be $44.4Gy{\cdot}cm2$ and $298.6Gy{\cdot}cm2$, respectively; the corresponding DRLs of fluoroscopy time were shown to be 191.5s and 1935.3s, respectively. A DRL is not a strict upper bound for radiation exposure. However, the process of setting, enacting, and reviewing the DRLs for the dose by medical institutions will contribute to a reduction in the unnecessary exposure dose of patients.
The use of cardiac angiography (CA) and the interventional procedures is rapidly increasing due to the increase in modern adult diseases. Cardiovascular intervention (CI) is an examination method where radiation is applied to the same area for a long period, and thus may cause skin injury. In this study, we investigate the diagnostic reference level (DRL) of the cardiovascular intervention (CI) carried out by medical institutions and use it as a tool to reduce patient exposure dose. In this study, the DRL was set by acquiring information about the cumulative fluoroscopy time, cumulative fluoroscopy dose-area product (DAP), radiography DAP, cumulative DAP, air kerma, number of video clips, and the total number of images from the cardiac angiography and interventional procedures performed on 147 patients. The DAPs corresponding to the DRL of cardiac angiography(CA) and that of the interventional procedures were shown to be $44.4Gy{\cdot}cm2$ and $298.6Gy{\cdot}cm2$, respectively; the corresponding DRLs of fluoroscopy time were shown to be 191.5s and 1935.3s, respectively. A DRL is not a strict upper bound for radiation exposure. However, the process of setting, enacting, and reviewing the DRLs for the dose by medical institutions will contribute to a reduction in the unnecessary exposure dose of patients.
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제안 방법
To acquire the dose information, the examination report saved in the control computer of the angiographic device was retrieved. For each examination, information was acquired about the cumulative fluoroscopy time, cumulative fluoroscopy dose-area product (DAP), cumulative radiography DAP, total cumulative DAP, air kerma, numb er of video clips, and total number of images. The angiographic device used for this study was Allura CV20 (Philips N.
1 kg, and the heights distributed between 140 cm and 176 cm showed an average of 159 cm. For the evaluation of the patient dose, the objects were divided into two groups: for one group, only cardiac angiography (CA) was carried out; for the other, the interventional procedures was carried out along with cardiac angiography (CA). The dose information provided by the angiographic device was analyzed.
In this study, we aim to set the DRLs by evaluating the exposure doses of cardiac angiography (CA) and the interventional procedures, and use them as a tool to reduce patient exposure to radiation.
For the evaluation of the patient dose, the objects were divided into two groups: for one group, only cardiac angiography (CA) was carried out; for the other, the interventional procedures was carried out along with cardiac angiography (CA). The dose information provided by the angiographic device was analyzed. To acquire the dose information, the examination report saved in the control computer of the angiographic device was retrieved.
대상 데이터
For each examination, information was acquired about the cumulative fluoroscopy time, cumulative fluoroscopy dose-area product (DAP), cumulative radiography DAP, total cumulative DAP, air kerma, numb er of video clips, and total number of images. The angiographic device used for this study was Allura CV20 (Philips N.V). The X-ray tube used for the angiographic device used 0.
7 mm focuses, and the X-ray target angle was 11°. The detector used was an amorphous silicon (aSi) detector with a CsI scintillator. The size of the detector was 40 cm x 20 cm, with a pixel size of 154 mm x 154 mm and a bit depth of 14.
The objects comprised 67 male patients and 80 female patients, with ages between 35 and 95 and an average age of 68.
The subjects in this study are 147 patients on whom cardiac angiography (CA) and cardiovascular interventions (CI) have been carried out between September 2015 and January 2016 in the cardiovascular center of a university hospital located in Gangwon-do, Korea. The objects comprised 67 male patients and 80 female patients, with ages between 35 and 95 and an average age of 68.
데이터처리
Frequency and bivariate correlation analyses were performed using SPSS Version 22 (IBM Corporation, USA) to set the DRL, using the third quadrant value of the dose information.
성능/효과
The DAPs corresponding to the DRL of cardiac angiography and the DRL of the interventional procedures investigated in this study were shown to be 44.4 Gy·cm2 and 298.6 Gy·cm2, respectively; the corresponding DRLs of fluoroscopy time were found to be 191.5 s and 1935.3 s, respectively.
The maximum, minimum, and average values of the total cumulative DAP were 796.3 Gy·cm2, 39.9 Gy·cm2, and 213.3 Gy·cm2, respectively.
참고문헌 (12)
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M. G. Delichas, K. Psarrakos, E. Molyvda-Athanassopoulou., et al : RADIATION DOSES TO PATIENTS UNDERGOING CORONARY ANGIOGRAPHY AND PERCUTANEOUS TRANS-LUMINAL CORONARY ANGIOPLASTY. Radiation Protection Dosimetry, 103(2), 149-154, 2003
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