ABSTRACT
Objective To evaluate the radiation dose of interventional procedure for children with congenital heart disease, and to analyze the differences in radiation dose and influencing factors. Methods A total of 94 children who underwent interventional procedure for congenital heart disease at a grade A tertiary hospital in Jinan, Shandong Province, China from June 2021 to September 2022 were included in this study. The patients were divided into three groups according to the type of procedure: ventricular septal defect occlusion group (VSD, 48 cases), patent ductus arteriosus occlusion group (PDA, 29 cases), and atrial septal defect occlusion group (ASD, 17 cases). The basic information of patients and postoperative dose reports were recorded. A statistical analysis was performed using SPSS software. Results The median cumulative air kerma (CAK) of VSD, PDA, and ASD was 100.5, 43.7, and 12.1 mGy, respectively. The median air kerma area product (KAP) of VSD, PDA, and ASD was 3.309, 1.313, and 0.540 Gy·cm2, respectively. The median KAP·kg−1 of VSD, PDA, and ASD was 0.179, 0.088, and 0.031 Gy·cm2·kg−1, respectively. There were significant differences in fluoroscopy time, number of cine images, CAK, KAP, and KAP·kg−1 among the three types of interventional procedures (P<0.05). Compared with PDA and ASD, VSD showed significantly higher fluoroscopy time, number of cine images, CAK, KAP, and KAP·kg−1 (P<0.05). Multiple linear regression analysis found that age (B=52.445, P<0.05), weight (B=13.077, P<0.05), fluoroscopy time (B=0.425, P<0.05), tube current (B=0.872, P<0.05), and number of cine images (B=0.660, P<0.05) were positively correlated with KAP, while there was no significant association between height and KAP (P>0.05). Conclusion There are differences in radiation dose among the three types of procedures. Reducing fluoroscopy time, tube current, and number of cine images while meeting the procedure requirements is of great significance for reducing the radiation dose received by children.
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Objective To investigate patient doses undergoing routine interventional cardiology procedures in China. Methods A retrospective analysis was performed on 238 adult patients who achieved one of interventional procedures including coronary angiography (CAG), percutaneous coronary angioplasty (PTCA) and radiofrequency catheter ablation (RF). According to intervention operations, all cases were divided into three groups:CAG (77), PTCA (95) and RF (66). Data of four special metrics, peak skin dose (PSD), dose-area product (DAP), cumulative dose (CD), and fluoroscopy time (FT), these parameters were measured and collected for these procedures. Frequencies of high-dose cases (PSD>2 Gy and PSD>3 Gy) were specifically recorded. Third quartile of DAP distribution was used to establish dose reference level (DRL) and then DRL values in this study were compared with ones reported in literatures. Wallis Kruskal rank-sum test was used to compare radiation dose of patients undergoing different intervention procedures. The total correlation among CD, DAP and PSD was analyzed by Spearman method. Results For patients undergoing CAG,PTCA and RF procedure, the median PSDs were 0.24, 1.05 and 0.62 Gy, respectively.The median DAPs were 34.99, 94.53 and 36.33 Gy · cm2, respectively.The median CDs were 0.39, 1.27 and 0.36 Gy, respectively.The median FTs were 4.50, 15.31 and 13.40 min, respectively. The difference among procedures was statistically significant (χ2=105.083, 92.032, 115.509, 100.883, respectively, P all cases, DAP and CD were correlative (r=0.845, P2 Gy, including 14 patients undergoing PTCA and 8 patients undergoing RF. There were 1.6% (22/238) patients with PSD>3 Gy, including 1 patients undergoing PTCA and 3 patients undergoing RF. The DRL for PTCA in this study is 133 Gy · cm2 and higher than that in literatures. The DRL for CAG in this study is 46 Gy · cm2 and slight lower than that in literatures. The DRL for RF in this study is 49 Gy·cm2. Conclusion Data from this study are in the range of most reported values for CAG and RF procedure, while higher than that obtained in some literatures for PTCA.
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PurposeTo explore and compare subtracted and unsubtracted volume rendering process on DSA apparatus in the diagnosis and treatment of intracranial aneurysms, and to provide a better reconstruction in clinic.Materials and Methods Twenty-seven patients with subarachnoid hemorrhage (SAH) underwent rotational cerebral angiography and 19 cases with embolization treatment underwent rotational cerebral angiography follow-up. 3D volume unsubtracted reconstruction and subtracted reconstructions were used respectively. Two sets of 3D volume reconstruction images were observed and analyzed by two neuroradiologists to compare the detection rate, image quality and post-embolization follow up.Results Thirty-three intracranial aneurysms were identiifed in 27 cases with SAH underwent three-dimensional digital angiography (3D-DA). False positives were found in 2 cases. 3D-DSA detected 33 intracranial aneurysms with no false positive case. There was no statistical signiifcance in intracranial aneurysms detection rate (χ2=1.943,P>0.05). There was no statistical significance in image quality of two reconstruction methods (Z=-1.445,P>0.05). In 19 cases with embolization treatment underwent the follow-up of rotational cerebral angiography, 3D-DA detected 3 cases with aneurysm remnants, while 3D-DSA detected 10. There was statistical signiifcance between 3D-DA and 3D-DSA when detecting aneurysm remnant (χ2=5.729,P<0.05).Conclusion Aneurysms can be well detected with better image quality by 3D-DSA and 3D-DA in the diagnosis and treatment of intracranial aneurysms. 3D-DSA can display more information on tiny vessels, and is better in detecting aneurysm remnants.