Ziliukas J, Morkunas G
Radiation Protection Centre, Kalvariju 153, LT-08221 Vilnius, Lithuania.
Radiat Prot Dosimetry. 2005;114(1-3):172-5. doi: 10.1093/rpd/nch529.
One of the most effective means towards optimisation of radiation protection for patients undergoing radiodiagnostic examinations are the diagnostic reference levels. In order to ensure the effective use of these levels, they have to be set properly. National characteristics, such as the conditions of the radiological equipments, the training of the staff, the availability of quality assurance systems, etc., have to be taken into account when these levels are established. Measurements under real conditions were considered as the best tools to achieve these reference levels. With an aim to establish the Lithuanian national diagnostic reference levels, the nationwide survey of entrance surface doses received by the patients during the most typical X-ray examinations has been performed. The most common types of examinations, such as chest PA, skull PA and LAT, abdomen AP, lumbar spine AP and LAT, thorax spine AP and LAT, and hip joint AP, were included in the list of procedures under consideration. Hospitals of different size and levels using different X-ray machines were represented in the survey. The standard thermoluminescence dosemeter techniques with pellets attached to the skin of the patient in the centre of radiation field were applied. The data were analysed statistically, and the averages and 75th percentile were calculated. The results show that the Lithuanian diagnostic reference levels might be rather close to the ones promoted by the International Atomic Energy Agency and the European Commission.
对于接受放射诊断检查的患者而言,优化辐射防护最有效的手段之一是诊断参考水平。为确保有效利用这些水平,必须对其进行合理设定。在确定这些水平时,必须考虑国家特性,如放射设备的状况、工作人员的培训、质量保证体系的可用性等。实际条件下的测量被视为实现这些参考水平的最佳工具。为了确定立陶宛的国家诊断参考水平,已对患者在最典型的X射线检查期间所接受的体表入射剂量进行了全国性调查。最常见的检查类型,如胸部后前位、头颅后前位和侧位、腹部前后位、腰椎前后位和侧位、胸椎前后位和侧位以及髋关节前后位,都被列入了所考虑的程序清单。调查涵盖了使用不同X射线机的不同规模和级别的医院。采用了标准热释光剂量计技术,将热释光剂量元件贴在患者皮肤位于辐射野中心的位置。对数据进行了统计分析,并计算了平均值和第75百分位数。结果表明,立陶宛的诊断参考水平可能与国际原子能机构和欧盟委员会所倡导的水平相当接近。