Division of Urology (Department of Surgery), Duke University Medical Center, Durham, North Carolina 27710, USA.
J Urol. 2012 Mar;187(3):920-4. doi: 10.1016/j.juro.2011.10.159. Epub 2012 Jan 20.
We measured organ specific radiation dose rates and determined effective dose rates during simulated ureteroscopy using a validated model. To calculate the effective dose, patients were exposed to ureteroscopic management of stones at our institution.
A validated anthropomorphic male phantom was placed on a fluoroscopy table and underwent simulated ureteroscopy. High sensitivity metal oxide semiconductor field effect transistor dosimeters were placed at 20 organ sites in the phantom and used to measure organ specific radiation doses. These dose rates were multiplied by the appropriate tissue weighting factor and summed to calculate effective dose rates. Also, we retrospectively reviewed the charts of patients who underwent ureteroscopy at our institution. A total of 30 nonobese males with data on fluoroscopy time were included in analysis. The median effective dose was determined by multiplying median fluoroscopy time by the effective dose rate.
The skin entrance was exposed to the highest absorbed dose rate, followed by the small intestine (mean ± SD 0.3286 ± 0.0054 and 0.1882 ± 0.0194 mGy per second, respectively). The mean effective dose rate was 0.024 ± 0.0019 mSv per second. Median fluoroscopy time was 46.95 seconds (range 12.9 to 298.8). The median effective dose was 1.13 mSv (range 0.31 to 7.17).
The fluoroscopy used during ureteroscopy contributes to overall radiation exposure in patients with nephrolithiasis. Nonobese males are exposed to a median of 1.13 mSv during ureteroscopy, similar to that of abdominopelvic x-ray. More data are needed to determine clinical implications but urologists must be aware and decrease patient radiation during ureteroscopy.
我们使用经过验证的模型测量了模拟输尿管镜检查过程中的器官特异性辐射剂量率，并确定了有效剂量率。为了计算有效剂量，我们让患者在我院接受了输尿管镜治疗结石。
将一个经过验证的男性人体模型放在透视台上，进行模拟输尿管镜检查。在模型中的 20 个器官部位放置高灵敏度金属氧化物半导体场效应晶体管剂量计，以测量器官特异性辐射剂量。将这些剂量率乘以适当的组织权重因子，并将其相加以计算有效剂量率。此外，我们还回顾性地查阅了在我院接受输尿管镜检查的患者的病历。共纳入 30 名非肥胖男性患者，其透视时间数据可供分析。通过将中位数透视时间乘以有效剂量率来确定中位数有效剂量。
皮肤入口处的吸收剂量率最高，其次是小肠（分别为 0.3286±0.0054 和 0.1882±0.0194 mGy/s）。平均有效剂量率为 0.024±0.0019 mSv/s。中位数透视时间为 46.95 秒（范围 12.9 秒至 298.8 秒）。中位数有效剂量为 1.13 mSv（范围 0.31 mSv 至 7.17 mSv）。
输尿管镜检查过程中的透视会增加肾结石患者的整体辐射暴露。非肥胖男性在输尿管镜检查中平均接受 1.13 mSv 的辐射，与腹盆腔 X 射线相似。需要更多的数据来确定临床意义，但泌尿科医生必须意识到并减少输尿管镜检查中的患者辐射。
