Kamusella P, Wissgott C, Wiggermann P, Scheer F, Andresen R
Institut für Diagnostische und Interventionelle Radiologie/Neuroradiologie, Westküstenklinikum Heide - Akademisches Lehrkrankenhaus der Universitäten Kiel, Lübeck und Hamburg.
Rofo. 2013 Mar;185(3):241-6. doi: 10.1055/s-0032-1330316. Epub 2013 Feb 12.
To evaluate whether a reduction in radiation exposure can be achieved using a direct dosimeter with an acoustic warning signal (model EDD-30, Unfors Instruments, Billdal, Sweden).
A total of 183 diagnostic and interventional angiographies of the pelvis and lower limbs using a direct dosimeter were analyzed. The vascular interventions were performed either by an experienced examiner (> 5000 interventions), an intermediate examiner (> 1000 interventions) or by a beginner (< 200 interventions). The measuring sensor of the direct dosimeter was attached to the back of the left hand, below the sterile glove, and was worn throughout the examination. If the limit values set on the dosimeter were exceeded, an acoustic signal sounded. At the end of the examination, the mean dose and the mean dose rate could be read off directly.
Exposure is clearly dependent on the experience of the examiner. The highest mean dose rate was found for the beginner, followed by the intermediate examiner. The lowest dose rate was shown by the experienced examiner, even though he mostly performed complex interventions. Over the course of 3 months, an improvement in the average dose rate can be shown in the third month for the intermediate examiner.
The use of a direct dosimeter with an acoustic warning signal is a practicable tool for sensitizing interventional radiologists to unavoidable radiation exposure, with the aim of reducing the dose. "Real-time" dosimetry represents a sensible extension of indirect protection of the radiation-exposed examiner in angiography.
评估使用带有声学警告信号的直接剂量仪（EDD - 30型号，Unfors Instruments公司，瑞典比尔达尔）是否能够降低辐射暴露。
分析了总共183例使用直接剂量仪的骨盆和下肢诊断性及介入性血管造影检查。血管介入操作由经验丰富的检查者（>5000例介入操作）、中级检查者（>1000例介入操作）或初学者（<200例介入操作）进行。直接剂量仪的测量传感器附着在左手背，无菌手套下方，并在整个检查过程中佩戴。如果剂量仪设定的限值被超过，就会发出声学信号。检查结束时，可直接读出平均剂量和平均剂量率。
辐射暴露明显取决于检查者的经验。初学者的平均剂量率最高，其次是中级检查者。经验丰富的检查者的剂量率最低，尽管他大多进行复杂的介入操作。在3个月的过程中，中级检查者在第三个月的平均剂量率有所改善。
使用带有声学警告信号的直接剂量仪是一种切实可行的工具，可使介入放射科医生意识到不可避免的辐射暴露，从而旨在降低剂量。“实时”剂量测定是对血管造影中受辐射检查者间接防护的合理扩展。
