Assessment of Patient Dose with Special Look at Pediatrics during Cardiovascular Imaging

Abstract

Aim: During interventional cardiology processes, patients especially women and children receive high radiation doses due to their sensitivities. In this study, we evaluated a pediatric patient dose separately in those undergone intervention cardiac procedure.Methods: In a public hospital with 252 patients, Entrance Skin Dose (ESD) and Dose-Area Product (DAP) were recorded. Prior to the beginning of fluoroscopic procedure, the chest thickness and Body Mass Index (BMI) of patients were measured. Furthermore, kV, mAs, an angle of tube and time of angiography and angioplasty were recorded.Results: Children ratio to all patients underwent the cardiovascular imaging was 1.8. The means of patients' ESD, DAP and fluoroscopy time were 178.3±17 mGy, 1123.6±11 μGym2 and 281.4±181.2 s, respectively for coronary angiography. In coronary angioplasty, the increase in ESD, DAP and fluoroscopy times were observed. In children with congenital heart disease, ESD mean, DAP and fluoroscopy time were 24.0±9.8 mGy, 147.8±62 μGym2, and 552±72s, respectively. The females were 96.8 under 30 years and their dose mean was 276±37 mGy, 368±24 μGym2 for ESD and DAP received, respectively with 376s fluoroscopy time. More than 37% of patients had (25-30) BMI. The relation between the patients’ BMI and DAP was significant (p=0.0001). Mean mAs was 359±34 and kV was 71.23±2.7. Above all, a direct and significant correlation was found between the patients’ chest thickness with variation kV (p=0.037, r=0.11) and mAs (p<0/001, r =0/28).Conclusion: The results demonstrated that the number of children referred to the cardiologic part of the heart and the also dose rate received by them during this test were higher than the data provided for children in developing countries, thus the factors causing such diseases require more attention. Moreover, the number of women was more than twice the referred patients to the heart imaging center, the doses received by these women can be causes of maternal diseases in children. Paying attention to the children's perception of high-fluorescence time is necessary in comparison with total angiography time in order to reduce the number of radiation injuries among pediatrics.