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介入手术室中眼晶状体暴露于辐射:需谨慎对待。

Eye lens exposure to radiation in interventional suites: caution is warranted.

作者信息

Vano Eliseo, Gonzalez Luciano, Fernández Jose M, Haskal Ziv J

机构信息

Department of Radiology, Complutense University, 28040 Madrid, Spain.

出版信息

Radiology. 2008 Sep;248(3):945-53. doi: 10.1148/radiol.2482071800. Epub 2008 Jul 15.

Abstract

PURPOSE

To report estimated radiation doses to the eye lens of the interventionalist from procedures performed with and without use of radiation protection measures.

MATERIALS AND METHODS

Scattered radiation doses for seven interventional radiology fluoroscopic systems were measured by using phantoms simulating patients 16-28 cm in thickness undergoing low-, medium-, and high-mode fluoroscopy, cine cardiac imaging, and digital subtraction angiography (DSA). The radiation doses to the eye lens in low- and high-dose scenarios were estimated. Beam angulation, biplanar equipment, working distance, procedure complexity, imaging collimation, and use of eyeglasses and/or protective suspended screens were taken into account. The doses to the lens in several procedures were assessed.

RESULTS

Mean scattered radiation doses to the lens during fluoroscopy were 6.0 and 34.5 microSv/min in the low- and high-dose scenarios, respectively. For DSA, typical doses to the lens ranged from 0.77 to 3.33 microSv per image. Operation modes involving increasing or decreasing radiation doses were quantified. For hepatic chemoembolization, iliac angioplasty, pelvic embolization, and transjugular intrahepatic portosystemic shunt creation, lens doses ranged from 0.25 to 3.72 mSv per procedure when protection was not used. Lens doses in the neuroembolization procedures could exceed 10 mSv per procedure.

CONCLUSION

With typical reported workloads, radiation doses to eye lenses may exceed the threshold for deterministic effects (ie, lens opacities or cataracts) after several years of work if radiation protection tools are not used.

摘要

目的

报告在使用和不使用辐射防护措施的情况下,介入医生眼部晶状体所接受的估计辐射剂量。

材料与方法

使用模拟厚度为16 - 28厘米患者的体模,对7个介入放射学透视系统的散射辐射剂量进行测量,这些患者正在接受低、中、高模式透视、心脏电影成像和数字减影血管造影(DSA)。估计了低剂量和高剂量情况下眼部晶状体的辐射剂量。考虑了射束角度、双平面设备、工作距离、操作复杂性、成像准直以及眼镜和/或防护悬吊屏的使用。评估了几种操作中晶状体的剂量。

结果

透视期间晶状体的平均散射辐射剂量在低剂量和高剂量情况下分别为6.0和34.5微希沃特/分钟。对于DSA,每张图像晶状体的典型剂量范围为0.77至3.33微希沃特。对涉及增加或减少辐射剂量的操作模式进行了量化。对于肝动脉化疗栓塞、髂血管成形术、盆腔栓塞和经颈静脉肝内门体分流术,在不使用防护措施时,每次操作晶状体剂量范围为0.25至3.72毫希沃特。神经栓塞操作中晶状体剂量每次操作可能超过10毫希沃特。

结论

根据典型的报告工作量,如果不使用辐射防护工具,工作几年后眼部晶状体的辐射剂量可能超过确定性效应(即晶状体混浊或白内障)的阈值。

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