Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
Pediatric Cardiology and Cardiac Surgery 37(1): 18-26 (2021)


小児心臓カテーテルにおける年代と技術の変遷に伴う被ばく低減の取り組みと効果面積線量積/体重比によるモニタリングの有用性Efforts and Effects of Reducing Radiation Exposure in Pediatric Cardiac Catheterization: Usefulness of Monitoring by Dose Area Product per Body Weight

1静岡県立こども病院循環器科Department of Cardiology, Shizuoka Children’s Hospital ◇ Shizuoka, Japan

2静岡県立こども病院放射線科Department of Radiology, Shizuoka Children’s Hospital ◇ Shizuoka, Japan

受付日:2020年8月11日Received: August 11, 2020
受理日:2020年11月16日Accepted: November 16, 2020
発行日:2021年4月1日Published: April 1, 2021



結果:DAP/BW [μGym2/kg]はA群,R群は③で低く[A群:①; 13.5, ②; 13.5, ③; 9.8, p<0.05, R群:①; 51.6,②; 33.4,③;20.5, p<0.05],C群では同等だった.B群,D群は③で高かった[B群:①; 76.8, ②; 108.5, ③; 117.0, p<0.05, D群:①; 41.0, ②; 45.1, ③; 46.0, p<0.05].


Background: Radiation exposure doses during pediatric catheterization may be effectively compared using dose area product per body weight (DAP/BW). Hence, we used DAP/BW to determine the effects of radiation dose reduction caused by era and technology change.

Methods: This study included 2757 patients (<15 years old) who underwent cardiac catheterization at our institute between 2008 and 2019. The procedure included transcatheter atrial septal defect closure (Group A; n=107), balloon dilatation for pulmonary stenosis (BAP) (Group B; n=117), coil embolization for aortopulmonary collateral arteries (Group C; n=395), diagnostic procedures (Group D; n=1918), and radiofrequency ablation (Group R; n=220). We compared the radiation doses during three time periods (period 1, 2008–2011; period 2, 2012–2016; period 3, 2017–2019).

Results: The DAP/BW levels decreased in Groups A and R at time period 3 (Group A: 1, 13.5; 2, 13.5; 3, 9.8; p<0.05; Group R: 1, 51.6; 2, 33.4; 3, 20.5; p<0.05). The DAP/BW in Group C remained unchanged. In Groups B and D, the DAP/BW was highest in period 3 (Group B: 1, 76.8; 2, 108.5; 3, 117.0; p<0.05; Group D: 1, 41.0; 2, 45.1; 3, 46.0; p<0.05).

Conclusion: In Groups A and R, radiation doses were reduced by changes in technology and experience. In Groups B and D, the radiation doses increased because of the complexity of the lesion or anatomy. Therefore, DAP/BW can be an indicator of radiation dose reduction in pediatric cardiac catheterizations.

Key words: cardiac catheterization; radiation exposure; dose area product per body weight; low pulse rate fluoroscopy; 3D rotational angiography

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