动态路图在冠状动脉低剂量模式中的应用

Application of dynamic coronary roadmap in coronary artery low-dose mode

目的评估联合应用动态冠状动脉路图(dynamic coronary roadmap,DCR)技术及低剂量冠脉模式是否可以进一步降低总放射剂量、透视时间和对比剂用量。方法 纳入2022年7月至2022年12月在上海市同济医院行冠脉造影患者94例,随机分为DCR组53例,对照组41例。DCR组应用冠状动脉动态路图指导行经皮冠状动脉介入(PCI)术,对照组采用低剂量冠脉造影模式进行手术。比较两组的总空气比释动能(air kerma,AK)、剂量面积乘积(DAP)、术中透视时间、对比剂用量。结果 与对照组相比,DCR组的AK明显减低,为(597.9±222.8) mGy比(717.0±326.8) mGy(P=0.039);DAP也显著减少,为(33.2±13.3) Gycm^(2)/s比(41.3±21.5) Gycm^(2)/s(P=0.027);DCR组的透视时间少于对照组,为(9.8±3.3) min比(12.1±4.3) min(P<0.01);两组对比剂用量无明显差异,为(122.3±19.0) mL比(130.5±28.5) mL(P=0.116)。结论 在低剂量冠脉介入治疗中应用动态冠脉路图模式,进一步降低了放射线剂量、透视时间及对比剂用量。

Objective To clarify whether the use of dynamic coronary artery roadmap(DCR)technology in a low-dose mode with 7.5 frames per second during coronary intervention can further reduce the total radiation dose,fluoroscopy time,and contrast agent usage.Methods A total of 94 patients,who received coronary angiography at the Shanghai Tongji Hospital of China between July 2022 and December 2022,were enrolled in this study.The patients were randomly divided into DCR group(n=53)and control group(n=41).DCR technology was used in the DCR group to guide the performance of percutaneous coronary intervention(PCI),while low-dose mode coronary angiography was adopted in the control group.The total air kerma(AK),dose-area product(DAP),intraoperative fluoroscopy time,and contrast agent usage were compared between the two groups.Results In the DCR group AK was(597.9±222.8)mGy,which was significantly lower than(717.0±326.8)mGy in the control group(P=0.039);DAP was(33.2±13.3)Gycm^(2)/s,which was also remarkably lower than(41.3±21.5)Gycm^(2)/s in the control group(P=0.027).In the DCR group and the control group,the intraoperative fluoroscopy time was(9.8±3.3)min and(12.1±4.3)min respectively(P<0.01),and the contrast agent usage was(122.3±19.0)mL and(130.5±28.5)mL respectively(P=0.116).Conclusion In a low-dose mode during coronary intervention,the use of DCR technology can further reduce radiation dose,fluoroscopy time,and contrast agent usage.