Chung Jae-Joon, Cho Eun-Suk, Kang Sung Min, Yu Jeong-Sik, Kim Dae Jung, Kim Joo Hee
Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, Korea.
Department of Radiology, CHA Bundang Medical Center, CHA University, Songnam, Korea.
Radiol Med. 2014 Dec;119(12):951-957. doi: 10.1007/s11547-014-0421-0. Epub 2014 Jun 6.
This study was done to investigate the efficacy of a lead shield in protecting the tissues outside the primary beams, such as the breast and thyroid, by measurement of the entrance skin dose during CT of the brain, neck, abdomen, and lumbar spine.
Institutional Review Board approval was obtained. This study included 150 patients (male:female 25:125, age range 15-45 years). In females, brain, lumbar spine, and abdominal CT scans, pre-/post-contrast neck CT scans, and post-contrast liver dynamic CT scans were performed. In males, brain CT scans only were performed. Breast shielding was performed in all females, and thyroid shielding was conducted in patients with brain CT. During all CT studies, the left breast or left thyroid was shielded using a lead shield, and the contralateral side was left unshielded. Thus, each breast or thyroid measurement had its own control for the same demographic data. The efficacy of the shielding of both breasts and thyroids during CT was assessed.
During brain, abdominal, lumbar, pre-/post-contrast neck, and post-contrast liver dynamic CT, 33.5, 26.0, 17.4, 26.5, and 16.2 % of the breast skin dose were reduced, respectively. During brain CT, the thyroid skin dose was reduced by 17.9 % (females) and 20.6 % (males). There were statistically significant differences in the skin doses of shielded organs (p < 0.05). Breast shielding during neck and liver dynamic CT was the most effective compared with breast or thyroid shielding during other CT scans.
We recommend breast shielding during neck and liver dynamic CT in young female patients to avoid unnecessary radiation exposure.
本研究旨在通过测量脑部、颈部、腹部和腰椎CT扫描期间的体表入射剂量，探讨铅屏蔽对保护主射束外组织（如乳房和甲状腺）的效果。
获得机构审查委员会批准。本研究纳入150例患者（男:女为25:125，年龄范围15 - 45岁）。女性患者进行脑部、腰椎和腹部CT扫描、颈部增强前后CT扫描以及肝脏增强动态CT扫描。男性患者仅进行脑部CT扫描。所有女性患者均进行乳房屏蔽，脑部CT扫描患者进行甲状腺屏蔽。在所有CT检查过程中，使用铅屏蔽对左侧乳房或左侧甲状腺进行屏蔽，对侧不进行屏蔽。因此，每个乳房或甲状腺测量都有相同人口统计学数据的自身对照。评估CT扫描期间乳房和甲状腺屏蔽的效果。
在脑部、腹部、腰椎、颈部增强前后以及肝脏增强动态CT扫描期间，乳房皮肤剂量分别降低了33.5%、26.0%、17.4%、26.5%和16.2%。在脑部CT扫描期间，女性甲状腺皮肤剂量降低了17.9%，男性降低了20.6%。屏蔽器官的皮肤剂量存在统计学显著差异（p < 0.05）。与其他CT扫描期间的乳房或甲状腺屏蔽相比，颈部和肝脏动态CT扫描期间的乳房屏蔽效果最佳。
我们建议年轻女性患者在颈部和肝脏动态CT扫描期间进行乳房屏蔽，以避免不必要的辐射暴露。
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