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儿科介入心脏病学中的散射剂量和术者剂量水平:一项多中心研究

Scatter and staff dose levels in paediatric interventional cardiology: a multicentre study.

作者信息

Ubeda Carlos, Vano Eliseo, Gonzalez Luciano, Miranda Patricia, Valenzuela Edith, Leyton Fernando, Oyarzun Carlos

机构信息

Department of Clinical Sciences, Faculty of Health Sciences, Tarapaca University, Arica, Chile.

出版信息

Radiat Prot Dosimetry. 2010 Jun;140(1):67-74. doi: 10.1093/rpd/ncq039. Epub 2010 Feb 16.

Abstract

Interventional cardiology procedures usually imply high doses to the staff, as paediatric cardiologists need to stay closer to the patient than during adult procedures. Also, biplane systems are used that imply an additional source of staff doses. The objective of this paper is to measure scatter doses in four X-ray systems, using polymethyl methacrylate phantoms with thicknesses ranging from 4 to 16 cm to simulate paediatric patients, for the different acquisition modes. Scatter dose rates measured at the position of cardiologist's eyes ranged from 0.8 to 12 mSv h(-1), and about twice the above values at lower extremities, as a linear function of the surface air kerma at the phantom, keeping the irradiated area constant. Therefore, the respective personal dose equivalent for the lens of the eyes may be around 0.5 and 1 mSv throughout the procedure, if additional protection is not used. Simultaneous cine acquisition in biplane systems yielded scatter doses to cardiologists, increased by factors from 5 to 21, compared with a single C-arm acquisition case and depending on geometry. Knowledge of scatter doses for different operation modes, patient thicknesses and the biplane operation should help paediatric cardiologists to adopt conservative attitudes in respect of their occupational radiation risks.

摘要

介入心脏病学手术通常意味着工作人员会受到高剂量辐射,因为儿科心脏病专家在手术过程中需要比成人手术时更靠近患者。此外,使用的双平面系统意味着工作人员会有额外的辐射剂量来源。本文的目的是使用厚度为4至16厘米的聚甲基丙烯酸甲酯体模来模拟儿科患者,针对不同的采集模式,测量四种X射线系统中的散射剂量。在心脏病专家眼睛位置测得的散射剂量率范围为0.8至12 mSv h⁻¹,在下肢位置约为上述值的两倍,这是体模表面空气比释动能的线性函数,且保持照射面积不变。因此,如果不采取额外防护措施,在整个手术过程中,眼睛晶状体的相应个人剂量当量可能约为0.5和1 mSv。与单C臂采集情况相比,双平面系统中的同步电影采集会使心脏病专家受到的散射剂量增加5至21倍,具体取决于几何形状。了解不同操作模式、患者厚度和双平面操作下的散射剂量,应有助于儿科心脏病专家对其职业辐射风险采取保守态度。

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