Rogits B, Jungnickel K, Löwenthal D, Kropf S, Nekolla E A, Dudeck O, Pech M, Wieners G, Ricke J
Radiology and Nuclear Medicine, University Magdeburg.
Rofo. 2013 Nov;185(11):1081-8. doi: 10.1055/s-0033-1350368. Epub 2013 Jul 29.
Assessment of radiologist's hand dose in CT-guided interventions and determination of influencing factors.
The following CT-guided interventions were included: Core biopsy, drainage, periradicular therapy, and celiac plexus neurolysis. The hand dose was measured with an immediately readable dosimeter, the EDD-30 (Unfors, Sweden). The default parameters for CT fluoroscopy were 120 kV, 90 mA and a 4 mm slice thickness. All interventions were performed on a 16-slice CT unit (Aquilion 16 Toshiba, Japan). The tumor size, degree of difficulty (1 - 3), level of experience and device parameters (mAs, dose-length product, scan time) were documented.
138 CT-guided interventions (biopsy n = 99, drainage n = 23, pain therapy n = 16) at different locations (lung n = 41, retroperitoneum n = 53, liver n = 25, spine n = 19) were included. The lesion size was 4 - 240 mm (median: 23 mm). The fluoroscopy time per intervention was 4.6 - 140.2 s (median: 24.2 s). The measured hand dose ranged from 0.001 - 3.02 mSv (median: 0.22 mSv). The median hand dose for lung puncture (n = 41) was slightly higher (median: 0.32 mSv, p = 0.01) compared to that for the liver, retroperitoneum and other. Besides physical influencing factors, the degree of difficulty (p = 0.001) and summed puncture depth (p = 0.004) correlated significantly with the hand dose.
The median hand dose for different CT-guided interventions was 0.22 mSv. Therefore, the annual hand dose limit would normally only be reached with about 2000 interventions.
评估CT引导介入操作中放射科医生手部的剂量并确定影响因素。
纳入以下CT引导介入操作：穿刺活检、引流、根管治疗及腹腔神经丛松解术。使用可即时读数的剂量仪EDD - 30（瑞典Unfors公司）测量手部剂量。CT透视的默认参数为120 kV、90 mA及4 mm层厚。所有介入操作均在16层CT设备（日本东芝Aquilion 16）上进行。记录肿瘤大小、难度等级（1 - 3级）、经验水平及设备参数（mAs、剂量长度乘积、扫描时间）。
纳入了138例不同部位（肺41例、腹膜后53例、肝脏25例、脊柱19例）的CT引导介入操作（活检99例、引流23例、疼痛治疗16例）。病变大小为4 - 240 mm（中位数：23 mm）。每次介入操作的透视时间为4.6 - 140.2 s（中位数：24.2 s）。测量的手部剂量范围为0.001 - 3.02 mSv（中位数：0.22 mSv）。与肝脏、腹膜后及其他部位相比，肺穿刺（41例）的手部剂量中位数略高（中位数：0.32 mSv，p = 0.01）。除物理影响因素外，难度等级（p = 0.001）和总穿刺深度（p = 0.004）与手部剂量显著相关。
不同CT引导介入操作的手部剂量中位数为0.22 mSv。因此，通常大约进行2000次介入操作才会达到年度手部剂量限值。
