| Summary: | 碩士 === 元培科學技術學院 === 影像醫學研究所 === 94 === Ranking among the ten major causes of death in Taiwan, the annual death toll from cardiovascular disease already exceeds 12,000 according to figures for 2004 from the Department of Health Executive Yuan, R.O.C.（Taiwan）. Significantly increasing the utilization frequency of clinical interventional cardiovascular fluoroscopy procedures can enable effective control of most heart diseases. However, patients who undergo cardiovascular procedures will had a certain level of radiation exposure, and the Entrance Skin Dose（ESD）is a key topic that requires further study. This investigation uses thermoluminescent dosimeter（TLD-100）as a measure for patient skin dose monitoring in a cardiac catheterization fluoroscopy procedure. To measure patient accumulated skin dose under different surgical procedures, the research statistics and data are analyzed using different procedures, and an in depth discussion is conducted.
The study obtains data from 51 patients and classifies it according to the procedures form: CAD（Coronary Artery Disease）、PTCA（Percutaneous Transluminal Coronary Angioplasty-one blood vessel）、PTCA（two blood vessel）and PTCA（three blood vessel）. In CAD, patient accumulated skin dose during cardiac catheterization procedures is 5.83 cGy、PTCA（1）is 12.10 cGy、PTCA（2）is 20.40 cGy、and PTCA（3）is 21.69 cGy. Following analysis, patient average skin dose is 1.065 cGy/min during cardiac catheterization procedures. Regarding thorax thickness, if patient thorax thickness is less than 20 centimeters, its average dose is 0.811 cGy/min. Meanwhile, the average dose is 1.13 cGy/min if the thorax thickness exceeds 20 cm. Additionally, influences on skin dose include the fluoroscope time、exposure time、number of exposures、frame rate and patient thorax thickness.
This investigation expects to be able to a reference documents in all large domestic medical institutes or hospitals. This study proposes that all medical institutes or hospitals should record statistics regarding patient exposure, and establishes the patient dose limit controlled by a standardization program in the relevant department. Based on the results, enabling further control of patients skin dose in cardiac catheterization procedures.
Keywords: Cardiac catheterization fluoroscopy,
thermoluminescent dosimeter, entrance skin dose
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