심장혈관검사에서 전산화단층검사와 혈관조영검사의 입사표면선량 및 조영제 사용량에 관한 분석
Analysis on the Entrance Surface Dose and Contrast Medium Dose at Computed Tomography and Angiography in Cardiovascular Examination
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심장혈관검사에서 전산화단층검사(cardiac computed tomography; CCTA)와 혈관조영검사(coronary angiography; CAG)의 입사표면선량을 후향적 방법으로 분석하여 선량의 저감화 방안을 알아보고 조영제 사용량을 실제 측정하여 신기능 저하 환자 및 부작용 발생 확률이 높은 환자 등의 검사 선택 결정에 대한 역할을 확인하고자 하였다. 양 검사의 입사표면선량인 전산화단층촬영지수(CTDIvol)값과 공기 커마(air kerma)값, 그리고 프레임 수에 따른 조영제 사용량 등을 비교·분석하였다. 실험 대상으로는 2014년 5월부터 2016년 5월까지 본원에서 CCTA와 CAG를 시행한 21명(남11, 여10)을 대상으로 하였고 연령대는 48~85세(평균 65±10세)이고, 몸무게는 37.6~83.3 kg(평균 63±6 kg)였다. CAG보다 CCTA를 이용한 심장혈관 검사가 선량의 감소를 기대할 수 있고 조영제 사용량에 있어서는 CCTA보다 CAG가 더 적은 양을 사용한다는 것을 알 수 있었다. 특히 CAG에서 프레임 수가 증가함에 따라 조영제 사용량이 늘어나므로 촬영범위에 적합한 프레임 수를 선택하여 검사 할수록 조영제 사용량을 더욱 감소시킬 수 있을 것으로 사료된다.
Abstract
This study aimed to identify dose reduction measures by retrospectively analyzing the entrance surface dose at computed tomography and angiography in cardiovascular examination and to contribute the patients with renal impairmend and a high probability of side effects to determine the inspection’s direction by measuring the contrast usages actually to active actions for the dose by actually measuring the contrast medium dose. The CTDIvol value and air kerma value, which are the entrance surface doses of the two examinations, and the contrast medium dose depending on the number of slides were compared and analyzed. This study was conducted in 21 subjects (11 males; 10 females) who underwent Cardiac Computed Tomographic Angiography (CCTA) and Coronary Angiography (CAG) in this hospital during the period from May 2014 to May 2016. The subject’s age was 48~85 years old (mean 65±10 years old), and the weight was 37.6~83.3 kg (mean 63±6 kg). Dose reduction could be expected in the cardiovascular examination using CCTA rather than in the examination using CAG. In terms of contrast medium dose, CAG used a smaller dose than CCTA. In particular, as the number of slides increases at CAG, the contrast medium dose increases. Therefore, in order to reduce the contrast medium dose, the number of slides suitable for the scan range must be selected.
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