• Title/Summary/Keyword: 뇌혈관 중재적 시술

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Reducing Radiation Exposure Dose on Operator by Using Lateral Protection in Neuro-Intervention (뇌혈관 중재적시술에 있어 측방향 차폐체를 이용한 시술자 피폭 선량 저감화 방법 연구)

  • Kim, Jongdeok;Ahn, ByeoungJu;Lee, Junhaeng
    • Journal of the Korean Society of Radiology
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    • v.8 no.1
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    • pp.1-10
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    • 2014
  • The bi-plane cerebrovascular angiography radiation is done the radiation exposure at the forward and lateral direction as opposed to the one of the source. So, the exposure dose of radiation workers increases further. Therefore, the medical diagnostic radiation workers as well as patients is interested to ways to reduce the dose. The exposure dose of cerebral angiography and interventional radiology must be considered the primary radiation of X-ray tube directly, scattered primary radiation between lateral tube and lateral detector and relatively small secondary scatter radiation in the walls of room. The aim of study is that the exposure dose of primary and scatter radiation reduce as much as possible to install protection device of lateral protection than common shielding of table and ceiling. As a result, the dose of fluoroscopy was reduced approximately 3.64 times the gonads, thyroid approximately 3.13 times, 4.42 times around eyes. And the dose of DSA was reduced approximately 4.98 times the gonads, thyroid approximately 3.00 times, 1.67 times around eyes. Consequently, medical practitioners can be helpful for radiation dose-exposure for the lateral protection of bi-plane cerebrovascular angiography more than the common shield method in cerebrovascular angiography and interventional radiological procedures.

Usefulness of Bismuth Shielding in Cerebral Vascular Intervention (뇌혈관 중재적 시술 시 Bismuth 차폐체 설치의 유용성에 대한 연구)

  • Kim, Jae-seok;Son, Jin-hyun;Kim, Young-kil
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2017.05a
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    • pp.179-182
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    • 2017
  • Cerebral nervous system intervention procedures have been reported frequently due to radiation exposure such as skin baldness, hair loss, and redness due to prolonged procedures. Therefore, the bismuth shield designed to reduce the radiation exposure of the target organ located in the anterior part of the human body sensitive to skin and radiation sensitivity during CT (computed tomography) scan is applied to the cerebral vascular system intervention by ergonomic design, To reduce the radiation dose of sensitive scalp, we propose a study.

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Study on Exposure Dose and Image Quality of Operator Using Shielding Material in Neuro Interventional Radiology (뇌혈관 중재적 시술에서 차폐체를 이용한 시술자의 피폭선량과 화질에 관한 연구)

  • Kim, Dae-ho;Kim, Sang-hyun;Lee, Young-jin;Lim, Jong-chun;Han, Dong-kyoon
    • Journal of the Korean Society of Radiology
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    • v.11 no.7
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    • pp.579-587
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    • 2017
  • Although interventional procedures use very low tube currents, there is a high risk of exposure to radiation as well as the operator due to long-term radiation exposure. The purpose of this study is to investigate the effects of radiation dose on the quality of the operator by measuring the dose received by the operator in the interventional procedure of the cerebral vascular system and finding the shielding material and shielding method which can effectively shield the exposure from the medical radiation. And to find a way to minimize it to the extent that it does not. As a result, when the newly designed shielding system with Nano Tungsten material was used, it was confirmed that the mean dose was reduced by 7.95% on average by the operator. Also, the PSNR results were measured to be 38.44 dB when using the designed shielding material, and it was confirmed that Nano Tungsten does not affect the image quality. In conclusion, the Nano Tungsten shielding material proved to be capable of significantly reducing the operator radiation dose, without affecting the image quality. The use of the above materials is expected to solve the problems related to the harmfulness and economical efficiency of the human body and the environment, which have recently become an issue of shielding materials.

A Study of Guide System for Cerebrovascular Intervention (뇌혈관 중재시술 지원 가이드 시스템에 관한 연구)

  • Lee, Sung-Gwon;Jeong, Chang-Won;Yoon, Kwon-Ha;Joo, Su-Chong
    • Journal of Internet Computing and Services
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    • v.17 no.1
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    • pp.101-107
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    • 2016
  • Due to the recent advancement in digital imaging technology, development of intervention equipment has become generalize. Video arbitration procedure is a process to insert a tiny catheter and a guide wire in the body, so in order to enhance the effectiveness and safety of this treatment, the high-quality of x-ray of image should be used. However, the increasing of radiation has become the problem. Therefore, the studies to improve the performance of x-ray detectors are being actively processed. Moreover, this intervention is based on the reference of the angiographic imaging and 3D medical image processing. In this paper, we propose a guidance system to support this intervention. Through this intervention, it can solve the problem of the existing 2D medical images based vessel that has a formation of cerebrovascular disease, and guide the real-time tracking and optimal route to the target lesion by intervention catheter and guide wire tool. As a result, the system was completely composed for medical image acquisition unit and image processing unit as well as a display device. The experimental environment, guide services which are provided by the proposed system Brain Phantom (complete intracranial model with aneurysms, ref H+N-S-A-010) was taken with x-ray and testing. To generate a reference image based on the Laplacian algorithm for the image processing which derived from the cerebral blood vessel model was applied to DICOM by Volume ray casting technique. $A^*$ algorithm was used to provide the catheter with a guide wire tracking path. Finally, the result does show the location of the catheter and guide wire providing in the proposed system especially, it is expected to provide a useful guide for future intervention service.

Evaluation of entrance surface dose and image quality according to the installation of Bismuth shield in the case of endovascular treatment of cerebral aneurysm (뇌동맥류 코일 색전술 시 Bismuth 차폐체 설치에 따른 입사 표면 선량 평가 및 화질 평가)

  • Kim, Jae-Seok;Kim, Young-Kil;Choi, Jae-Ho
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.23 no.7
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    • pp.779-785
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    • 2019
  • By applying an ergonomically developed Bismuth shield to the endovascular treatment of cerebral aneurysm the radiation dose of the scalp and lens from the medical radiation exposure was reduced. The enrtance surface dose was analyzed by measuring the occipital parts, bilateral temporal parts, bilateral quadriceps, and nasal tip of the developed bismuth shield using a photostimulable fluorescence dosimeter before (Group A) before use (Group B). Signal to noise ratio (SNR) and contrast to noise ratio (CNR) analysis were used to evaluate the image quality when Bismuth shielding was used. The mean entrance surface dose of A group and B group was 26.92% lower than that of A group. The analysis of CNR and SNR was the same for both Roadmap and DSA. The use of Bismuth shielding is an alternative that can reduce the radiation impairment due to temporary hair loss and other stochastic effects that may occur after cerebrovascular intervention.

Evaluation of Patient Radiation Doses Using DAP Meter in Interventional Radiology Procedures (인터벤션 시술 시 면적선량계를 이용한 환자 방사선 선량 평가)

  • Kang, Byung-Sam;Yoon, Yong-Su
    • Journal of radiological science and technology
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    • v.40 no.1
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    • pp.27-34
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    • 2017
  • The author investigated interventional radiology patient doses in several other countries, assessed accuracy of DAP meters embedded in intervention equipments in domestic country, conducted measurement of patient doses for 13 major interventional procedures with use of Dose Area Product(DAP) meters from 23 hospitals in Korea, and referred to 8,415 cases of domestic data related to interventional procedures by radiation exposure after evaluation the actual effectives of dose reduction variables through phantom test. Finally, dose reference level for major interventional procedures was suggested. In this study, guidelines for patient doses were $237.7Gy{\cdot}cm^2$ in TACE, $17.3Gy{\cdot}cm^2$ in AVF, $114.1Gy{\cdot}cm^2$ in LE PTA & STENT, $188.5Gy{\cdot}cm^2$ in TFCA, $383.5Gy{\cdot}cm^2$ in Aneurysm Coil, $64.6Gy{\cdot}cm^2$ in PTBD, $64.6Gy{\cdot}cm^2$ in Biliary Stent, $22.4Gy{\cdot}cm^2$ in PCN, $4.3Gy{\cdot}cm^2$ in Hickman, $2.8Gy{\cdot}cm^2$ in Chemo-port, $4.4Gy{\cdot}cm^2$ in Perm-Cather, $17.1Gy{\cdot}cm^2$ in PCD, and $357.9Gy{\cdot}cm^2$ in Vis, EMB. Dose referenece level acquired in this study is considered to be able to use as minimal guidelines for reducing patient dose in the interventional radiology procedures. For the changes and advances of materials and development of equipments and procedures in the interventional radiology procedures, further studies and monitorings are needed on dose reference level Korean DAP dose conversion factor for the domestic procedures.

Effects of Self-Made Bismuth Shield Installation on Entrance surface Dose Reduction during Endovascular Treatment of Cerebral Aneurysms (뇌동맥류 코일 색전술시 자체 제작한 Bismuth 차폐체 설치의 피부선량 감소 효과)

  • Kim, Jae-Seok;Kim, Young-Kil;Choi, Jae-Ho
    • Journal of the Korean Society of Radiology
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    • v.13 no.2
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    • pp.175-183
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    • 2019
  • Cerebral nervous system intervention has been reported frequently due to radiation exposure such as blistering of the skin, hair loss, and erythema due to prolonged procedures. By applying ergonomically manufactured Bismuth (atomic number 83; Bi) shield to endovascular treatment of cerebral aneurysms, we aimed to minimize radiation exposure of scalp and lens from medical radiation exposure. The measurement site was the posterior part of the head, bilateral temporal part, bilateral quadriceps part, nose part, and the measuring part was attached to the optically stimulated Luminescence dosimeter (OSLD) Before and after the use, the entrance surface dose was compared and analyzed. The average entrance surface dose of group A (unshield) was 92.44 mGy, and group B was measured at 67.55 mGy. The average decrease in Group B was 26.92% compared to Group A. The entrance surface dose mean of the occipital region was measured at 146.08 mGy B group at 103.23 mGy and decreased by an average of 29.32% in group B compared to group A. The average entrance surface dose of the bilateral temporal part was measured in group A at 101.90 mGy group B at 72.69 mGy and decreased by an average of 28.67% in group B compared to group A. The average entrance surface dose for bilateral quadriceps part was measured at 27.51 mGy group B at 21.39 mGy and averaged 22.26% less in group B than group A. It is believed that the use of bismuth shields will be an alternative to reducing radiation disturbance due to temporary hair loss and other stochastic effects that may occur after the endovascular treatment of cerebral aneurysms procedure.

Long-term Clinical Outcomes after Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction-on the basis of 65 Years (급성 심근경색증 환자에서 일차적 관상동맥 중재술 후 장기적 임상 경과-65세를 기준으로)

  • Lee, Han-Ol;Jang, Seong-Joo;Kim, In-Soo;Han, Jae-Bok;Park, Soo-Hwan;Kim, Jeong-Hun;Jang, Young-Ill
    • The Journal of the Korea Contents Association
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    • v.14 no.5
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    • pp.251-261
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    • 2014
  • Primary percutaneous coronary intervention (PCI) has been found to be superior, in terms of hospital mortality and long-term outcome, compared with thrombolytic therapy in patients with acute myocardial infarction (AMI). However, the clinical benefits of primary PCI have not been precisely evaluated in elderly patients.1,974 patients (Group I: n=1,018, $age{\geq}65years$, $73.8{\pm}5.99years$; Group II: n=956, age<65years, $52.8{\pm}7.96years$) who underwent primary PCI for AMI at Chonnam National University Hospital between 2006 and 2010 were analyzed according to their clinical, angiographic characteristics for hospital and one-year survival. Group I had a higher percentage of women, diabetes mellitus, hypertension, multi-vessel disease and lower prevalence of current smoking, hyperlipidemia, familial history than Group II. Culprit lesions were at the left anterior descending artery, left circumflex artery, right coronary artery and left main artery in 42.8% vs. 45.0%, 34.1% vs. 29.6%, 14.6% vs 14.6, 2.7% vs. 1.6%, respectively (p=0.007). Stent diameter was smaller in group I ($3.17{\pm}0.39$ vs. $3.29{\pm}0.42mm$, p=0.001). In-hospital mortality was higher in group I (8.4 vs. 1.9%, p<0.001). There were significant differences in the rates of major adverse cardiac events between the two groups during one-year clinical follow-up (20.1 vs.14.0%, p<0.001). On multiple logistic regression analysis, systolic blood pressure<100mmHg, serum $creatinine{\geq}1.3mg/dL$, Killip class> I, multivessel disease, left ventricular ejection fraction <40% and cerebro vascular disease were independent predictors of one-year motality in patients over 65 years after PCI.