Astudy On Patient Doses In3D-DSA Procedures

Purpose：using DSA fluoroscopy time, image frames, cumulative dose（CD）,dose-area product（DAP）, to determine whether there were correlation each other,todetermine whether estimate the entrance skin doses （ESD） by these techniques.Todetermine patients distribution of systemic doses in the three-dimensional DSA.Methods： Randomly selected168CAG cases and53PVP cases,measuredfluoroscopy time, photographic frames, dose area product （DAP）, cumulative dose（CD）by digital subtraction angiography（DSA）machine with penetrate the ionizationchamber dose monitoring system. Radiation dose were measured in a total of30patientsincluding38CAG cases and15PVP cases,including the lateral, three-dimensionalrotational angiography and soft tissue imaging. Entrance skin doses（ESD） for53patientswere measured by thermoluminescent dosimeters（TLDs）；The dose index,defined as theratio between ESD and cumulative dose（CD）,was also calculated．doses distributionmeasured by TLDs in the CAG and PVP procedures with3D-DSA.Results：The correlation showed highly both the photography（perspective）time、photographic frames、CD and DAP in the221cases（p<0.001，r=0.901、0.820、0.833、0.845、0.823）.But in the individual cases, the correlation is poor. CD in39CAG cases（17.64%） and18PVP cases（8.14%） cases are greater than1Gy and in only one PVPcase greater than2Gy.the correlation between DAP and ESD, CD and ESD is highly（p<0.001, r=0.780,0.956）.The dose index is less than1,which showed CD overestimatedESD.Data showed that radiation doses on the head were highest in three-dimensionalangiography during CAG,and the single maximum dose was113.8mGy.Radiation doseson the chest, abdomen, hip were higher during PVP procedure,and the single maximumdose was191.39mGy.Conclusions：In the CAG and PVP procedure, there were very high correlation bothphotography time、 photographic frames、CD and DAP.The radiation doses in PVP procedure maybe lead to skin injury,and the doses should be recorded.The highest radiationdoses in the goal of the site during the3D-DSA,and the highest single dose was within thesafe range.The correlation between CD and ESD、DAP and ESD was highly.So we canuse regression to estimate ESD from CD or DAP. The radiation doses of patients can berecorded in real-time detection during the IVR procedure.It has important significance tomake patient radiation dose as low as reasonably achievement.