Wagner L K, Archer B R, Cohen A M
Department of Radiology, The University of Texas-Houston Health Science Center Medical School, 77030, USA.
J Vasc Interv Radiol. 2000 Jan;11(1):25-33. doi: 10.1016/s1051-0443(07)61274-3.
To simulate dose to the skin of a large patient for various operational fluoroscopic conditions and to delineate how to adjust operational conditions to maintain skin dose at acceptable levels.
Patient entrance skin dose was estimated from measurement of entrance air kerma (dose to air) to a 280-mm water phantom for two angiographic fluoroscopes. Effects on dose for changes in machine floor kVp, source-to-skin distance, air gap, electronic magnification, fluoroscopic dose rate control settings, and fluorographic dose control settings were examined.
Incremental changes in operational parameters are multiplicative and markedly affect total dose delivered to a patient's skin. For long procedures, differences in doses of 8 Gy or more are possible for some combinations of operational techniques.
Effects on skin dose from changes in operational parameters are multiplicative, not additive. Doses in excess of known thresholds for injury can be exceeded under some operating conditions. Adjusting operational parameters appropriately will markedly reduce dose to a patient's skin. Above all other operational factors, variable pulsed fluoroscopy has the greatest potential for maintaining radiation exposure at low levels.
模拟在各种透视操作条件下大型患者皮肤所接受的剂量，并阐述如何调整操作条件以使皮肤剂量保持在可接受水平。
通过测量两台血管造影透视机对280毫米水模体的入射空气比释动能（空气剂量）来估算患者入射皮肤剂量。研究了机器管电压、源皮距离、空气间隙、电子放大倍数、透视剂量率控制设置和摄影剂量控制设置的变化对剂量的影响。
操作参数的增量变化是相乘的，并且显著影响输送到患者皮肤的总剂量。对于长时间的操作，某些操作技术组合可能导致剂量差异达到8 Gy或更大。
操作参数变化对皮肤剂量的影响是相乘的，而非相加的。在某些操作条件下，可能会超过已知的损伤阈值剂量。适当调整操作参数将显著降低患者皮肤的剂量。在所有其他操作因素中，可变脉冲透视在将辐射暴露维持在低水平方面具有最大潜力。
