RESUMO
The pilot dose survey on paediatric general radiography, fluoroscopy and CT procedures was performed in four university hospitals. The analysis of data was focused on the radiography and CT imaging of head, chest, abdomen, pelvis and spine and fluoroscopic procedures of gastrointestinal and urinary tracts. The survey was conducted by the National Radiation Protection Institute. Two hospitals exported data from the patient dose management system, while the others collected the data manually. The methodology of diagnostic reference levels assessment was proposed and tested. Local diagnostic reference levels were calculated in terms of air kerma-area product $P_{KA}$, CT air kerma-length product $P_{KL,CT}$ and volumetric CT air kerma index $C_{VOL}$. The lack of procedure standardisation, e.g. in tube voltage setting irrespective of patient's weight, was revealed at one hospital. Dose and exposure parameters distributions with respect to patient's anatomical constitution are presented in this article. In future, this pilot study will be a base for national survey of paediatric diagnostic reference levels.
Assuntos
Fluoroscopia/métodos , Gastroenteropatias/diagnóstico por imagem , Órgãos em Risco/efeitos da radiação , Exposição à Radiação/análise , Radiografia Intervencionista/métodos , Tomografia Computadorizada por Raios X/métodos , Doenças Urológicas/diagnóstico por imagem , Criança , República Tcheca , Humanos , Processamento de Imagem Assistida por Computador/métodos , Projetos Piloto , Doses de Radiação , Proteção RadiológicaRESUMO
Transradial approach to coronary angiography is a progressive and increasingly more often used technique. Apart from its advantages, radial artery occlusion (RAO) represents the most serious drawback. Re-canalization of an iatrogenic RAO, although asymptomatic in the majority of cases, remains a discussed and challenging topic. Besides its clear indications in symptomatic patients, it still remains questionable whether to perform this procedure in order to enable future repeated cannulations using the same access site and preserving the other remaining sites. For this particular reason we performed an antegrade re-canalization of an unrecognized RAO, likely a result of a previous transradial approach intervention. After a failed radial approach, the intervention was successfully performed via an ipsilateral ulnar artery. Following an uncomplicated coronary re-catheterization, RAO was angiographically diagnosed and re-canalized via the same (ulnar) access site using standard coronary equipment. Radial and ulnar artery patency were examined and checked on the following day and one month later using duplex ultrasonography.
