Shortt C P, Al-Hashimi H, Malone L, Lee M J
Department of Radiology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
Cardiovasc Intervent Radiol. 2007 Nov-Dec;30(6):1206-9. doi: 10.1007/s00270-007-9071-0. Epub 2007 May 29.
The purpose of this study was to investigate the radiation doses to the lower extremities in interventional radiology suites and evaluate the benefit of installation of protective lead shielding. After an alarmingly increased dose to the lower extremity in a preliminary study, nine interventional radiologists wore thermoluminescent dosimeters (TLDs) just above the ankle, over a 4-week period. Two different interventional suites were used with Siemens undercouch fluoroscopy systems. A range of procedures was carried out including angiography, embolization, venous access, drainages, and biopsies. A second identical 4-week study was then performed after the installation of a 0.25-mm lead curtain on the working side of each interventional table. Equivalent doses for all nine radiologists were calculated. One radiologist exceeded the monthly dose limit for a Category B worker (12.5 mSv) for both lower extremities before lead shield placement but not afterward. The averages of both lower extremities showed a statistically significant dose reduction of 64% (p < 0.004) after shield placement. The left lower extremity received a higher dose than the right, 6.49 vs. 4.57 mSv, an increase by a factor of 1.42. Interventional radiology is here to stay but the benefits of interventional radiology should never distract us from the important issue of radiation protection. All possible measures should be taken to optimize working conditions for staff. This study showed a significant lower limb extremity dose reduction with the use of a protective lead curtain. This curtain should be used routinely on all C-arm interventional radiologic equipment.
本研究的目的是调查介入放射科手术中下肢所受的辐射剂量，并评估安装防护铅屏蔽的益处。在一项初步研究中发现下肢剂量惊人地增加后，9名介入放射科医生在4周时间里在脚踝上方佩戴热释光剂量计（TLD）。使用了两台配备西门子床下透视系统的不同介入手术室。进行了一系列操作，包括血管造影、栓塞、静脉通路建立、引流和活检。然后在每个介入手术台的工作侧安装了0.25毫米铅帘后，又进行了为期4周的相同研究。计算了所有9名放射科医生的当量剂量。一名放射科医生在放置铅屏蔽前双下肢超过了B类工作人员的月度剂量限值（12.5毫希沃特），但放置后未超过。放置屏蔽后，双下肢的平均剂量显示出统计学上显著的64%的剂量降低（p<0.004）。左下肢所受剂量高于右下肢，分别为6.49毫希沃特和4.57毫希沃特，增加了1.42倍。介入放射学已成为常规操作，但介入放射学的益处绝不应使我们忽视辐射防护这一重要问题。应采取一切可能措施优化工作人员的工作条件。本研究表明，使用防护铅帘可显著降低下肢剂量。这种铅帘应在所有C形臂介入放射设备上常规使用。
