Objectives: There is an increasing use of three-dimensional rotational angiography (3D-RA) during catheterization of congenital heart disease. Dose-area-product (DAP) measured by the angiography system and computed-to...Objectives: There is an increasing use of three-dimensional rotational angiography (3D-RA) during catheterization of congenital heart disease. Dose-area-product (DAP) measured by the angiography system and computed-tomography dose index (CTDI) do not appear practical for dose assessment. Hence, we performed real dose measurements in anthropomorphic phantoms. Methods: Three different anthropomorphic phantoms (10 kg, 19 kg and 73 kg bodyweight) equipped with thermoluminescent dosimeters (TLD) were used. We used a typical standard diagnostic program and a low-dose program. The effective dose (ED) was calculated according to the International Commission on Radiological Protection (ICRP) 103. The 3D distribution of radiation in the body was assessed. Results: ED for the male 10 kg phantom was 0.192 mSv in the diagnostic program and 0.050 mSv (male) in the low-dose program. The 19 kg phantom received an ED of 0.205 mSv (male) in the diagnostic program. In the low-dose program the ED reached 0.058 mSv (male). The male adult 73 kg phantom was exposed with an ED of 0.730 mSv in the diagnostic program and 0.282 mSv in the low-dose program. ED for the female phantoms was slightly higher for both acquisition-programs. Dose distribution was inhomogeneous with a dose maximum in the esophageal region behind the heart, whereas in the brain, intestine and gonads we found nearly no radiation. Conclusions: 3D-RA imaging in the interventional catheter laboratory is possible with an effective dose lower than 1 mSv. With its potential to reduce fluoroscopic time and the number of control angiographies in catheterization and intervention in complex anatomy, it can decrease the radiation dose.展开更多
Background Dual-axis rotational coronary angiography （DARCA） was developed as an innovative adaptation of rotational angiography （RA）, but it requires a longer coronary injection compared to standard coronary angi...Background Dual-axis rotational coronary angiography （DARCA） was developed as an innovative adaptation of rotational angiography （RA）, but it requires a longer coronary injection compared to standard coronary angiography （SA）. As the body of the average Chinese patient is smaller than that of most western patients, with the same contrast injection time, the risk of complications from the contrast agent is increased in this population. The purpose of this study was to assess the clinical safety and efficacy of DARCA in the diagnosis of coronary artery disease （CAD） in the Chinese population by directly comparing it to SA. Methods Two hundred Chinese patients were randomized to either the SA group （n=100） or DARCA group （n=100）. Contrast utilization, radiation exposure and procedure time were recorded for each modalities. Blood pressure （BP）, heart rate （HR） pre and post injection symptoms and any arrhythmias were recorded. Results Compared to the SA group, there was a 42% reduction in contrast utilization, 55% reduction in radiation exposure and a 31% shorter procedure time in the DARCA group. In both groups, there were slight declines in the systolic BP values in the left coronary artery （LCA） post injection （P 〈0.01）. Moreover, post injection HRs for the LCA were also reduced in the DARCA group （P 〈0.01）. But all of these changes were small, transient and without clinical importance. Only one patient （1%） in the DARCA group had an attack of ventricular tachycardia immediately post injection and it resolved by itself during LCA angiography. No arrhythmias occurred in the SA group. Conclusion DARCA is a safe, efficient, and clinically comparable alternative to SA in the diagnosis of coronary artery disease in the Chinese population with less contrast utilized, which is less radiation exposure and a shorter procedure展开更多
文摘Objectives: There is an increasing use of three-dimensional rotational angiography (3D-RA) during catheterization of congenital heart disease. Dose-area-product (DAP) measured by the angiography system and computed-tomography dose index (CTDI) do not appear practical for dose assessment. Hence, we performed real dose measurements in anthropomorphic phantoms. Methods: Three different anthropomorphic phantoms (10 kg, 19 kg and 73 kg bodyweight) equipped with thermoluminescent dosimeters (TLD) were used. We used a typical standard diagnostic program and a low-dose program. The effective dose (ED) was calculated according to the International Commission on Radiological Protection (ICRP) 103. The 3D distribution of radiation in the body was assessed. Results: ED for the male 10 kg phantom was 0.192 mSv in the diagnostic program and 0.050 mSv (male) in the low-dose program. The 19 kg phantom received an ED of 0.205 mSv (male) in the diagnostic program. In the low-dose program the ED reached 0.058 mSv (male). The male adult 73 kg phantom was exposed with an ED of 0.730 mSv in the diagnostic program and 0.282 mSv in the low-dose program. ED for the female phantoms was slightly higher for both acquisition-programs. Dose distribution was inhomogeneous with a dose maximum in the esophageal region behind the heart, whereas in the brain, intestine and gonads we found nearly no radiation. Conclusions: 3D-RA imaging in the interventional catheter laboratory is possible with an effective dose lower than 1 mSv. With its potential to reduce fluoroscopic time and the number of control angiographies in catheterization and intervention in complex anatomy, it can decrease the radiation dose.
文摘Background Dual-axis rotational coronary angiography （DARCA） was developed as an innovative adaptation of rotational angiography （RA）, but it requires a longer coronary injection compared to standard coronary angiography （SA）. As the body of the average Chinese patient is smaller than that of most western patients, with the same contrast injection time, the risk of complications from the contrast agent is increased in this population. The purpose of this study was to assess the clinical safety and efficacy of DARCA in the diagnosis of coronary artery disease （CAD） in the Chinese population by directly comparing it to SA. Methods Two hundred Chinese patients were randomized to either the SA group （n=100） or DARCA group （n=100）. Contrast utilization, radiation exposure and procedure time were recorded for each modalities. Blood pressure （BP）, heart rate （HR） pre and post injection symptoms and any arrhythmias were recorded. Results Compared to the SA group, there was a 42% reduction in contrast utilization, 55% reduction in radiation exposure and a 31% shorter procedure time in the DARCA group. In both groups, there were slight declines in the systolic BP values in the left coronary artery （LCA） post injection （P 〈0.01）. Moreover, post injection HRs for the LCA were also reduced in the DARCA group （P 〈0.01）. But all of these changes were small, transient and without clinical importance. Only one patient （1%） in the DARCA group had an attack of ventricular tachycardia immediately post injection and it resolved by itself during LCA angiography. No arrhythmias occurred in the SA group. Conclusion DARCA is a safe, efficient, and clinically comparable alternative to SA in the diagnosis of coronary artery disease in the Chinese population with less contrast utilized, which is less radiation exposure and a shorter procedure
