Stoeckelhuber Beate M, Schulz Edda, Melchert Uwe H, Blobel Jörg, Gellissen Jörg, Gehl Hans, Weiss Hans D, Leibecke Thorsten
Institut für Radiologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck.
Rontgenpraxis. 2003;55(2):51-7.
To assess the techniques, indications and radiation exposures incurred with CT fluoroscopy.
A 1-year period of use of CT fluoroscopy to guide diagnostic and therapeutic interventional procedures was analyzed. The spectrum of indications, different CT fluoroscopic methods and radiation exposures for the radiologist were assessed. Scatter exposures were measured with and without placement of a lead drape on the patient, with and without use of thin rubber radiation protection gloves. In addition, scattered radiation was determined for a combination of lead drape and radiation protection gloves.
There is a wide variety for the use of CT fluoroscopy ranging from diagnostic biopsy procedures to therapeutic interventions such as radiofrequency ablation of liver metastases and CT fluoroscopy-guided osteosynthesis of fractures. Scatter exposure rates to the radiologists hand ranged from 1-320 microSv/case without use of a lead drape and without radiation protection gloves. The lead drape reduced the scattered exposure for the radiologists hand by 72%. Radiation protection gloves reduced scatter radiation by 49%. The combination of both radiation protection devices was most effective in decreasing the dose by 97%.
CT fluoroscopy is a useful targeting method with a wide variety for interventional procedures. However, significant radiation exposures may occur. Therefore, the radiologists should be aware of different techniques of CT fluoroscopy guidance and the methods to reduce scatter radiation.
评估CT透视引导技术、适应证及辐射暴露情况。
分析为期1年的CT透视引导诊断和治疗性介入操作的使用情况。评估适应证范围、不同的CT透视方法以及放射科医生所受的辐射暴露。在患者身上放置铅帘和不放置铅帘、使用和不使用薄橡胶辐射防护手套的情况下测量散射暴露。此外,还测定了铅帘和辐射防护手套联合使用时的散射辐射。
CT透视的应用范围广泛,从诊断性活检操作到治疗性干预,如肝转移瘤的射频消融和CT透视引导下骨折的接骨术。在不使用铅帘和不使用辐射防护手套的情况下,放射科医生手部的散射暴露率为1 - 320微希沃特/病例。铅帘可使放射科医生手部的散射暴露降低72%。辐射防护手套可使散射辐射降低49%。两种辐射防护装置联合使用对降低剂量最为有效,可降低97%。
CT透视是一种有用的介入操作靶向方法,应用范围广泛。然而,可能会发生显著的辐射暴露。因此,放射科医生应了解CT透视引导的不同技术以及减少散射辐射的方法。