Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, H118, New York, NY 10065, USA.
J Vasc Interv Radiol. 2010 Nov;21(11):1703-7. doi: 10.1016/j.jvir.2010.07.019.
To evaluate the impact of common radiation-shielding strategies, used alone and in combination, on scattered dose to the fluoroscopy operator's eye.
With an operator phantom positioned at the groin, upper abdomen, and neck, posteroanterior low-dose fluoroscopy was performed at the phantom patient's upper abdomen. Operator lens radiation dose rate was recorded with a solid-state dosimeter with and without a leaded table skirt, nonleaded and leaded (0.75 mm lead equivalent) eyeglasses, disposable tungsten-antimony drapes (0.25 mm lead equivalent), and suspended and rolling (0.5 mm lead equivalent) transparent leaded shields. Lens dose measurements were also obtained in right and left 15° anterior obliquities with the operator at the upper abdomen and during digital subtraction angiography (two images per second) with the operator at the patient's groin. Each strategy's shielding efficacy was expressed as a reduction factor of the lens dose rate compared with the unshielded condition.
Use of leaded glasses alone reduced the lens dose rate by a factor of five to 10; scatter-shielding drapes alone reduced the dose rate by a factor of five to 25. Use of both implements together was always more protective than either used alone, reducing dose rate by a factor of 25 or more. Lens dose was routinely undetectable when a suspended shield was the only barrier during low-dose fluoroscopy.
Use of scatter-shielding drapes or leaded glasses decreases operator lens dose by a factor of five to 25, but the use of both barriers together (or use of leaded shields) provides maximal protection to the interventional radiologist's eye.
评估单独和联合使用的常见辐射屏蔽策略对透视操作员眼部散射剂量的影响。
将操作员模拟体置于腹股沟、上腹部和颈部,在上腹部对模拟患者进行后前位低剂量透视。使用固态剂量计,在操作员佩戴有、无含铅桌裙、无铅和含铅(0.75 毫米铅当量)眼镜、一次性钨-锑帘(0.25 毫米铅当量)以及悬挂式和滚动式(0.5 毫米铅当量)透明含铅屏蔽的情况下,记录操作员晶状体的辐射剂量率。还在操作员处于上腹部的情况下,测量右和左 15°前斜视时的晶状体剂量,并在操作员处于患者腹股沟的情况下,进行数字减影血管造影术(每秒两帧)时,测量晶状体剂量。每种策略的屏蔽效果均表示为与未屏蔽条件相比晶状体剂量率的降低倍数。
单独使用含铅眼镜可将晶状体剂量率降低五到十倍;单独使用散射屏蔽帘可将剂量率降低五到二十五倍。两种器械一起使用始终比单独使用更具保护作用,可将剂量率降低二十五倍或更多。在低剂量透视期间,仅使用悬挂式屏蔽时,晶状体剂量通常无法检测到。
使用散射屏蔽帘或含铅眼镜可将操作员晶状体剂量降低五到二十五倍,但同时使用两种屏障(或使用含铅屏蔽)可最大程度地保护介入放射科医生的眼睛。