数字减影血管造影低剂量技术在经皮肝穿刺胆道引流术中的应用

Application of DSA low-dose technique in percutaneous transhepatic biliary drainage

目的探讨低剂量DSA技术和荧光透视在经皮肝穿刺胆道引流术(PTCD)临床应用的可行性。方法收集住院患者共86例,随机分为标准模式剂量采集组(A组,n=43)及低剂量模式采集组(B组,n=43),由科室同一医师完成PTCD手术。对两组患者手术平均指标对比分析并进行t检验。2名放射科影像医师采取盲法对所有图像进行评分。结果两组患者均顺利完成PTCD手术,应用t检验方法,平均曝光时间[(251±16)s、(249±20)s]、图像质量评分[(3.60±0.5)s、(3.56±0.5)s],标准体重BMI[(2.81±0.25)kg/m^2、(2.85±0.25)kg/m^2]数值比较,P≥0.05,无统计学差异;累积剂量[(87.1±6.1)mGy、(54.4±7.7)mGy]、辐射剂量面积乘积[(2935.2±353)μGy·cm^2、(1566.3±200)μGy·cm2]方面分析,P<0.05,差异有统计学意义。结论采取低剂量DSA采集技术在PTCD手术患者有效可行,并且可以显著减低患者所受辐射剂量。

Objective To investigate the feasibility of clinical application of digital subtraction angiography(DSA)low-dose technique and fluoroscopy in performing percutaneous transhepatic cholangial drainage(PTCD).Methods A total of 86 inpatients were randomly divided into group A(n=43,using standard mode dose acquisition)and group B(n=43,using low-dose mode acquisition).PTCD procedure in all patients was performed by the same physician in the department.The average indexes of PTCD were compared between the two groups and analyzed with t-test.Using a double-blind method,all the images were scored by two radiologists.Results Successful PTCD procedure was accomplished in all patients.The results of t-testing indicated that no statistically significant differences in average exposure time[(251±16)s vs.(249±20)s],image quality score[(3.60±0.5)s vs.(3.56±0.5)s]and body mass index(BMI)[(2.81±0.25)kg/m^2 vs.(2.85±0.25)kg/m2]existed between group A and group B(P≥0.05),while statistically significant differences in cumulative dose[(87.1±6.1)mGy vs.(54.4±7.7)mGy]and radiation dose area product[(2935.2±353)μGy·cm^2 vs.(1566.3±200)μGy·cm^2]existed between group A and group B(P<0.05).Conclusion For the performance of PTCD procedure,DSA low-dose acquisition technique is effective and feasible,this technique can remarkably reduce the radiation dose to the patient.(J Intervent Radiol,2019,28:986-990)