Practical techniques for reducing radiation exposure during cerebral angiography procedures
Practical techniques for reducing radiation exposure during cerebral angiography procedures
复制标题
DOI：
10.1136/neurintsurg-2013-010982
复制
发表时间：
2015-02-01
影响因子：
4.8
通讯作者：
Gailloud, Philippe
中科院分区：
文献类型：
--
作者：
Pearl, Monica S.;Torok, Collin;Gailloud, Philippe
目的DSA是目前评价脑血管疾病，特别是脑动脉瘤和血管畸形的金标准影像学方法。本研究的目的是证明修改DSA帧频、透视和路线图脉冲率以及平板探测器（FPD）位置对体模中脑血管造影常规视图中辐射剂量的影响。材料和方法使用成人颅骨和腹部/骨盆拟人体模，比较辐射剂量度量Ka，r（单位为mGy），PKA，（单位：mu Gym（2））和透视时间在脑血管造影的三个组成部分中修改荧光透视每秒脉冲（p/s）、DSA每秒帧数（f/s）以及FPD位置和准直后的时间（分钟）：（1）股动脉入路，（2）路线图引导，（3）双平面脑DSA。DSA方案导致的剂量显著高于仅使用荧光透视的剂量（p=0.007）。使用3 p/s或4 p/s的路线图输送的剂量显著低于较高脉率（p=0.008）。双平面脑DSA的递送剂量范围为347.3-1188.5 mGy和3914.54-9518.78 mu Gym（2）。最低的辐射剂量所产生的可变帧率DSA protocols.Conclusions取代股动脉血管通路的DSA与荧光透视评价，利用低脉冲率在荧光透视和路线图的指导下，并选择可变帧率DSA是简单的技术，可以考虑由操作者在其临床实践中，以降低辐射剂量在脑血管造影程序。
Purpose DSA remains the gold standard imaging method for the evaluation of many cerebrovascular disorders, in particular cerebral aneurysms and vascular malformations. The purpose of this study was to demonstrate the effect of modifying DSA frame rate, fluoroscopic and roadmap pulse rates, and flat panel detector (FPD) position on the radiation dose delivered during routine views for a cerebral angiogram in a phantom model.Materials and methods Adult skull and abdomen/pelvis anthropomorphic phantoms were used to compare the radiation dose metrics Ka, r (in mGy), PKA (in mu Gym(2)), and fluoroscopy time (in minutes) after modification of fluoroscopic pulses per second (p/s), DSA frames per second (f/s), and FPD position and collimation in three components of a cerebral angiogram: (1) femoral artery access, (2) roadmap guidance, and (3) biplane cerebral DSA.Results For femoral artery access, DSA protocols resulted in significantly higher doses than those utilizing fluoroscopy alone (p=0.007). Roadmaps using 3 p/s or 4 p/s delivered significantly less dose than higher pulse rates (p=0.008). The ranges of delivered doses for biplane cerebral DSA were 347.3-1188.5 mGy and 3914.54-9518.78 mu Gym(2). The lowest radiation doses were generated by the variable frame rate DSA protocols.Conclusions Replacing femoral arterial access evaluations by DSA with fluoroscopy, utilizing lower pulse rates during fluoroscopy and roadmap guidance, and choosing variable frame rates for DSA are simple techniques that may be considered by operators in their clinical practices to lower radiation dose during cerebral angiography procedures.