Picano Eugenio, Santoro Gennaro, Vano Eliseo
CNR, Institute of Clinical Physiology, Via Moruzzi, 1, Pisa 56124, Italy.
Int J Cardiovasc Imaging. 2007 Apr;23(2):143-7. doi: 10.1007/s10554-006-9148-x. Epub 2006 Oct 11.
Use of radiation for medical examinations and test is the largest man-made source of radiation exposure. Interventional procedures are only 2% of all radiological procedures, but contribute to about 20% of the total collective dose per head per year. On average, a left ventriculography and coronary angiography corresponds to a radiation exposure for the patient of about 300, a coronary stent to 1,000, a peripheral artery intervention to 1,500 to 2,500, and a cardiac radiofrequency ablation to 900-1,500 chest x-rays. Invasive cardiology procedures increased tenfold in the last ten years and growth in the field has been accompanied by concern for the safety of the staff. Interventional cardiologists have an exposure per-head per year two- to three times higher than that of radiologists, with an annual exposure equivalent to around 250 chest x-rays per head. A reduction of occupational doses by a factor of ten can be achieved simply by and intensive training program. The awareness of radiation effects may be suboptimal in the medical community. It is recommended by professional guidelines and reinforced by the European law that the responsibility of all physicians is to minimize the radiation injury hazard to their patients, to their professional staff and to themselves.
将辐射用于医学检查和测试是最大的人为辐射暴露源。介入程序仅占所有放射程序的2%,但约占每人每年集体总剂量的20%。平均而言,一次左心室造影和冠状动脉造影相当于患者接受约300次胸部X光的辐射剂量,冠状动脉支架置入术为1000次,外周动脉介入术为1500至2500次,心脏射频消融术为900 - 1500次胸部X光。在过去十年中,侵入性心脏病学程序增加了十倍,该领域的发展伴随着对工作人员安全的担忧。介入心脏病学家每人每年的辐射暴露量比放射科医生高出两到三倍,每年的暴露量相当于每人约250次胸部X光。通过强化培训计划,职业剂量可降低至十分之一。医学界对辐射影响的认识可能并不理想。专业指南建议并由欧洲法律强化,所有医生的责任是将对患者、专业人员和自身的辐射损伤危害降至最低。