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Objective:To collect the date of radiation dose in reference air kerma(AK) and dose-area product (DAP) values in order to evaluate the feasibility of fluoroscopy time as a monitoring and warning indicator of radiation exposure in cardiovascular interventions.Methods:The study conducted a retrospective analysis of 736 patients who underwent coronary angiography(CAG)and percutaneous coronary intervention(PCI)from November 2016 to January 2018 in Shanghai Changhai Hospital. Based on the imaging equipments(a Siemens Ceiling system and a Siemens Biplane system)and cardiovascular interventions(CAG and PCI), the fluoroscopy time, AK values and DAP values were collected. The correlation of the radiation dose and fluoroscopy time was analyzed using Spearman correlation statistics.Results:The mean values of fluoroscopy time, fluoroscopy AK, total AK, fluoroscopy DAP and total DAP were(8.9±7.8)min, (472±474), (703±595)mGy, (4 578±4 085)and(6 253±4 938)μGy·m 2 for Ceiling system and(8.6±7.3)min, (510±509), (733±614)mGy, (4 255±3 781)and (5 681±4 432)μGy·m 2 for Biplane system, respectively. The mean values of CAG and PCI fluoroscopy time were(2.4±0.9)and(15.7±4.9)min, respectively.The ratio of fluoroscopy radiation dose (AK and DAP) to total dose was 74% and 78% in PCI procedures. There was a strongly correlation between fluoroscopy time and total AK ( r=0.822) or total DAP ( r=0.844) in cardiovascular interventions ( P<0.001). Conclusions:The radiation dose of fluoroscopy acquisition is the main source of overall radiation dose in cardiovascular interventions. Radiation dose is expected to increase as fluoroscopy time increases.The fluoroscopy timer as a protective tool of radiation exposure has a good reference and warning value in the clinical application of cardiovascular interventions.
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Objective To evaluate the application value of Smart Mask technology guiding micro-catheter in place for intracranial aneurysm embolization in endovascular interventional treatment. Methods The DSA data of 61 consecutive patients with unruptured intracranial aneurysm in the Department Neurosurgery,Changhai Hospital,the Second Military Medical University from August 5 to December 20,2016 were collected retrospectively. The conditions of the guildewire catheter reaching the aneurysms and the coil embolization in the Smart Mask technology group (n = 31)and conventional road map group (n = 30)were compared. The observation indexes included the differences in contrast agent dosage,exposure time,and operation time. Results The contrast agent dosage of the Smart Mask technology group and road map technology group were 192 ± 37 and 215 ± 40 ml respectively,the X-ray illumination quantity were 5913 ±1682 and 6975 ±2036 mGy respectively,and the operation time were 2. 62 ± 0. 29 h and 2. 94 ± 0. 35 h respectively. The differences were statistically significant (all P < 0. 05 ). Conclusion Using Smart Mask technology to assist endovascular embolization of intracranial aneurysms can effectively shorten the operation time,reduce the amount of X-ray radiation and contrast agent,and reduce the risk of operation.
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Objective To evaluate the efficacy of the DAP database in reducing radiation hazards during cardiovascular intervention.Methods The study conducted a retrospective analysis of all consecutive cardiovascular cases in the database from April 1st,2016 to June 30th,2016.Based on the imaging systems,an inage intensifier (Ⅱ) and a flat panel detector (FPD),the cases of patients undergoing coronary angiography (CAG) and percutaneous coronary interventions (PCI) were collected to observe Body Mass Index (BMI),fluoroscopy time (FT) and dose area product (DAP).Results The FT and DAP values in CAG were (3.26-±2.59) min and (1 938±1 296) μGy·m2 for the Ⅱ system and (3.00 ± 2.89) min and (3 718 ± 2 859) μGy· m2 for the FPD system,respectively,whereas,the FT and DAP values in PCI were (17.81 ± 12.71) min and (8 899 ±7 032) μGy·m2 for the Ⅱ system and (21.99 ± 15.91) min and (19 526 ± 14 134) μGy · m2 for the FPD system,respectively.The differences in DAP values (x ± s) for CAG and PCI between the angiography systems were significant(t =-10.664,11.239,P ＜ 0.05).The DAP and total DAP values during PCI for fluoroscopy from the FPD systen were 3 596 755.60 and 4 881 484.50 μGy · m2,respectively.Conclusions The DAP values in CAG and PCI using FPD system are much higher than the relevant data.The use of an FPD system resulted in higher DAP values compared to the Ⅱ system in cardiovascular interventional procedures.Reduction in fluoroscopy time may decrease radiation hazards during PCI.The DAP database allows for a fast,convenient and enough objective data to discovery timely difference and variation in dose in cardiovascular interventional procedures.
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Objective To investigate the relationship between body mass index (BMI) and dose area product (DAP) as well as fluoroscopy time during coronary angiography (CAG) in Han nationality subjects in order to improve early judging and reducing high radiation risk. Methods CAG materials of 451 Han nationality subjects were retrospectively analyzed. The patients included 276 males (age 32-87 years) and 175 females (age 42-84 years), and the BMI values ranged from 17.30 to 35.42 kg/m2. According to BMI values, the patients were divided into group A(BMI30 kg/m2,n=30). The mean DAP and fluoroscopy time of each group were calculated; the DAP values were compared between each other among the four groups by using nonparametric Kruskal-Wallis test, while the fluoroscopy time was compared between each other among the four groups by using single factor analysis of variance or LSD-t test. Results The mean DAP of group A, B, C and D was(1 070.07±541.33) μGym2,(1 326.82±606.91) μGym2,(1 937.99±1 030.31) μGym2 and (2 654.53±1 296.69) μGym2 respectively. The mean fluoroscopy time of group A, B, C and D was (3.53± 2.08) min, (2.70 ±1.80) min, (2.75 ±1.88) min and (2.71 ±1.69) min respectively. Statistically significant difference in DAP values existed between each other among the four groups (P0.05). Conclusion The DAP values of adult Han subjects receiving CAG are increased with the increase of BMI values; the fluoroscopy time is significantly prolonged in patients with BMI<20 kg/m2. In performing interventional procedure, the operator should not only understand that the increase of BMI can cause the increase of DAP, but also need to pay special attention to the increase of DAP value caused by operation difficulty when the patient’s BMI is <20 kg/m2.