hrvatski

Ispitivanje i optimiziranje doza zračenja koje bolesnik apsorbira tijekom koronarnih intervencija

Interventional cardiology procedures are classified as high-dose procedures, owing to increased risk for radiation skin injuries and stochastic effects, such as cancer. Many international and national studies investigated radiation dose to patient during fluoroscopy guided cardiology procedures. Dose received by a patient, in general, depends on the radiological equipment, examination protocol, the way iti is implemented, the patient's body weight and nature of disease. Long term fluoroscopy of certain parts oft he body, a significant body mass, high-value dose intensity, continuous rather than pulsed fluoroscopy, small focus-skin distance and repeated procedure on the same patient, are among the factors that can lead to radiation skin injuries. Euroepean Union Medical Exposures Directive 97/43 Euroatom strongly recommned patient dosimetry in interventional radiology, indcluding IC. IC patient radiation doses in four representative IC rooms in Croatia were investigated. Local and national diagnostic reference levels were proposed as a guidance. A total of 151 retrospective and 751 prospective therapeutic (PTCA, stenting) procedures were included. Patient irradiation was measured in terms of kerma-area product (KAP), fluoroscopy time (FT) and number of cine-frames (F). KAP was recored using calibrated KAP-meters. DRLs of KAP, FT and F were calculated as third quartile values rounded up to the integer. Skin doses were assessed on a selected sample of high skin dose procedures, using radiochromic films, and peak skin doses (PSD) were presented. Large range od doses in IC was detected. National DRLs were proposed as follows 32 Gy cm2, 6, 6 min and 610 frames for CA and 72 Gy cm2, 19 min and 1270 frames for PTCA. The doses recorded int he study are acceptable when compared with the literautre, but optimisation is possible. The were no deterministic skin effects in these group of patients detected, but shown range of demonstrate that such events are possible. We recommend regular quality assurance measurements and staf education.

intervencijska kardiologija ; optimizacija ; doze zračenja

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