Kallmes David F, O Erwin, Roy Soma Sinha, Piccolo Richard G, Marx William F, Lee Jae K, Jensen Mary E
Department of Radiology, University of Virginia, Charlottesville, VA, USA.
AJNR Am J Neuroradiol. 2003 Jun-Jul;24(6):1257-60.
Percutaneous vertebroplasty procedures require relatively long durations of fluoroscopic guidance, which might lead to substantial radiation dose to operators. Specialized injection devices have been proposed to limit operator exposure. Our purpose was to compare the radiation dose to the operator's hands during vertebroplasty when using 1-cc syringes versus that when using an injection device.
Radiation dosimeters were worn on the left wrist during 39 vertebroplasty injection procedures in 25 patients. Cases were alternated between the use of 1-cc syringes (19 procedures) and the use of an injection device (20 procedures). For each procedure, one dosimeter was worn throughout the procedure, both during needle placement and injection, and a second dosimeter was worn during the injection phase only. Mean doses for the whole case and mean doses for the injection procedure alone were compared between groups.
Mean whole case dose was 128 +/- 161 mrem (range, 0-660 mrem) for the 1-cc syringe group versus 98 +/- 90 mrem (range, 0-340 mrem) for the injection device group (P =.23). Mean dose during injection was 100 +/- 145 mrem (range, 0-660 mrem) for the 1-cc syringe group versus 55 +/- 43 mrem (range, 0-130 mrem) for the injection device group (P =.09). Three of 19 1-cc syringe cases yielded zero dose, compared with four of 20 injection device cases. Duration of injection was markedly different between groups, with mean injection times of 4.2 and 7.5 min for 1-cc syringe and injection device cases, respectively (P <.00002). Mean injection dose per minute of lateral fluoroscopy was 23.6 and 7.3 mrem for the 1-cc syringe and injection device groups, respectively (P =.002).
The use of an injection device significantly decreased the radiation dose to the operator's extremity per unit time of injection. However, total dose per injection was equivalent between groups because of significantly longer injection duration for the injection device cohort.
经皮椎体成形术需要较长时间的透视引导，这可能会给操作人员带来大量辐射剂量。已提出使用专门的注射装置来限制操作人员的辐射暴露。我们的目的是比较在椎体成形术期间，使用1毫升注射器与使用注射装置时操作人员手部所接受的辐射剂量。
在25例患者的39次椎体成形术注射过程中，在操作人员左手腕佩戴辐射剂量仪。病例交替使用1毫升注射器（19例）和注射装置（20例）。对于每次操作，在整个操作过程中，包括进针和注射期间，佩戴一个剂量仪，仅在注射阶段佩戴第二个剂量仪。比较两组的整个病例平均剂量和仅注射过程的平均剂量。
1毫升注射器组的整个病例平均剂量为128±161毫雷姆（范围0 - 660毫雷姆），而注射装置组为98±90毫雷姆（范围0 - 340毫雷姆）（P = 0.23）。1毫升注射器组注射期间的平均剂量为100±145毫雷姆（范围0 - 660毫雷姆），注射装置组为55±43毫雷姆（范围0 - 130毫雷姆）（P = 0.09）。19例使用1毫升注射器的病例中有3例剂量为零，而20例使用注射装置的病例中有4例剂量为零。两组之间的注射持续时间明显不同，1毫升注射器组和注射装置组的平均注射时间分别为4.2分钟和7.5分钟（P < 0.00002）。1毫升注射器组和注射装置组每分钟侧位透视的平均注射剂量分别为23.6毫雷姆和7.3毫雷姆（P = 0.002）。
使用注射装置可显著降低每单位注射时间操作人员肢体所接受的辐射剂量。然而，由于注射装置组的注射持续时间明显更长，两组每次注射的总剂量相当。
