陳拓榮Tou-Rong Chen官聖學Sheng-Xue Kuan醫學影像暨放射科學系2026-03-269999-12-312019https://handle.ncl.edu.tw/11296/7kbgxahttps://scholars.csmu.edu.tw/handle/123456789/7531隨著心導管檢查複雜程度提高以及病患越來越年輕化，有必要追蹤病患檢查後所接受的有效劑量，以利評估輻射致癌風險及降低病患輻射劑量。透過劑量面積乘積(dose area product, DAP)轉換有效劑量之轉換因數可快速算出有效劑量。 本研究根據心導管臨床治療條件分成透視(Fluoro)和照相(Cine)兩種模式及後前位(PA)、側位(LAT)兩種X光投射角度，並使用0、1、5、10、成人擬人型假體分別以兩種方法評估接受檢查後的有效劑量：(1)佈點TLD(2)蒙地卡羅模擬，並將求得之有效劑量除上曝露之DAP即可算出轉換因數。本研究另以回溯性方法，蒐集PCI病患術後的劑量資訊，將不同模式下病患的DAP乘上實驗求得之對應轉換因數，即可評估檢查後病患所接受到的有效劑量。 研究結果顯示不論在哪一種模式LAT轉換因數值皆大於PA，隨者年齡越小轉換因數值越大，除了0歲結果外，不同攝影模式下轉換因數的差異皆小於10%。本次研究共蒐集50位PCI病患，平均年齡、身高、體重為66歲、161cm、68kg，DAP的中位數為214(Gy ‧ cm^2)，有效劑量的中位數為76.8mSv，轉換因數為0.32 mSv / Gy ‧ cm^2。 本研究提供了不同攝影模式及投影角度下的轉換因數，PA與LAT轉換因數須各別使用對應的轉換因數，透過本研究提供的轉換因數，心導管檢查後可根據病患的劑量資訊快速進行有效劑量的估算。As the complexity of cardiac catheterization increases and the patient becomes younger, it is necessary to track the effective dose received to assess the risk of radiation-induced cancer. The effective dose can be quickly calculated by conversion factor which is converting the dose area product (DAP) through the effective dose. According to the clinical treatment conditions of cardiac catheterization, this study was divided into two modes: fluoroscopy and photographic (Cine) with posterior anterior (PA) and lateral (LAT) X-ray projection angles. We used 0, 1, 5, 10 and adult anthropomorphic phantom to evaluates the effective dose after the examination in two ways: (1) TLD (2) Monte Carlo simulation. Finally we calculate the conversion factor by dividing the obtained effective dose by the exposed DAP. In this study, a retrospective method was used to collect the postoperative dose information of PCI patients. The DAP of patients in different modes was multiplied by the corresponding conversion factor obtained by the experiment to evaluate the effective dose received by the patients after the examination. The results show that the LAT conversion factor value is greater than PA in any mode. The smaller the age, the larger the conversion factor value. In addition to the 0-year result, the difference of conversion factors in different photography modes is less than 10%. A total of 50 PCI patients were enrolled in the study. The mean age, height, and weight were 66 years, 161 cm, and 68 kg. The median DAP was 214 Gycm2, effective dose was 76.8 mSv and conversion factor is 0.32 mSv / Gycm2. This study provides conversion factors for different X-ray projection angles and. Through the conversion factor provided in this study, the effective dose can be quickly estimated based on the patient''s dose information.心導管轉換因數有效劑量cardiac catheterizationconversion factoreffective dosethesis