脑血管介入放射诊治中患者的X射线辐射评价

Evaluation of Radiation Exposure for Patients in Cerebral Vessels Interventional Neuroradiology Procedures

目的 研究DSA方式介入性脑血管造影诊断与脑血管栓塞治疗过程中患者所受X射线辐射。方法 10 0例脑部病变患者 ,脑血管造影诊断 68例、脑血管栓塞治疗 3 2例。Siemens公司DSA机Angiostar Plus随机配置剂量监测系统 (DiamentorK1andDiamentorED) ,在线测量面积剂量乘积DAP(cGycm2 )和入射表面剂量ESD(mGy)、采用Monte Carlo转换因子估算有效剂量ED(mSv)。结果 本组病例一次IVNR的DAP、ESD、ED值分别为 ( 11916± 7499)cGycm2 、( 973± 682 )mGy、( 12 5 9± 9 12 )mSv。其中造影诊断组的剂量分别为 ( 92 64± 3 777)cGycm2 、( 741± 3 2 1)mGy、( 10 0 1± 6 85 )mSv ,血管栓塞治疗组的剂量分别为 ( 175 5 3± 10 0 2 7)cGycm2 、( 14 96± 95 2 )mGy、( 18 0 6± 10 90 )mSv ,两组的差异具有显著性意义。摄影剂量 [DAP(mSv)、mGy] /透视 [DAP(mSv)、mGy]的比值 ,分别为 7 5 2± 6 44、6 14± 4 72。结论 在IVNR诊治过程中 ,患者受到大剂量X射线辐射 ,其摄影剂量均值数倍于透视剂量 。

Objective To study X-ray radiation exposure of patients during cerebral angiography and cerebral vessel embolisation by DSA model. Methods 100 brain disease cases in this serial, of them, angiographic diagnosis in 68 cases, and ebolization therapy in 32 patients. Angiostar-Plus(Siemens) equipped dose measure system(Diamentor K1 and Diamentor ED) was used, dose values was on-line recording: dose-area product(DAP, cGycm 2), and enter skin dose(ESD, mGy). The effective dose(ED, mSv) was estimated by Monte-Carlo conversion coefficient from DAP. Results In this study total patient radiation exposure mean dose were (11?916±7?499)cGycm 2、(973±682)mGy、(12.59±9.12)mSv, respectively, in angiography group. The mean dose were(9?264±3?777)cGycm 2、(741±321)mGy、(10.01±6.85)mSv, and in embolization group (17?553±10?027)cGycm 2、(1?496±952)mGy、(18.06±10.90)mSv. There was statistics difference between two groups(P<0.05). The dose ratio of radiography/fluoroscopy were 7.52±6.44(DAP、ED) and 6.14±4.72(ESD), respectively. Conclusion The patients fall under large dose radiation exposure during interventional neuroradiology procedures. The mean dose in radiography was 6～7 times more than that in fluoroscopy. The best method of decreasing patients X-ray exposure is reducing total radiograph frames.