1 Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, ON, Canada.
AJR Am J Roentgenol. 2014 Dec;203(6):1336-44. doi: 10.2214/AJR.13.11445.
The purpose of this study was to determine the range of effective doses associated with imaging techniques used during interventional radiology procedures on children.
A pediatric phantom set (1, 5, and 10 years) coupled with high-sensitivity metal oxide semiconductor field effect transistor (MOSFET) dosimeters was used to calculate effective doses. Twenty MOSFETs were inserted into each phantom at radiosensitive organ locations. The phantoms were exposed to mock head, chest, and abdominal interventional radiology procedures performed with different geometries and magnifications. Fluoroscopy, digital subtraction angiography (DSA), and spin angiography were simulated on each phantom. Road mapping was conducted only on the 5-year-old phantom. International Commission on Radiological Protection publication 103 tissue weights were applied to the organ doses recorded with the MOSFETs to determine effective dose. For easy application to clinical cases, doses were normalized per minute of fluoroscopy and per 10 frames of DSA or spin angiography.
Effective doses from DSA, angiography, and fluoroscopy were higher for younger ages because of magnification use and were largest for abdominal procedures. DSA of the head, chest, and abdomen (normalized per 10 frames) imparted doses 2-3 times as high as corresponding doses per minute of fluoroscopy while all other factors remained unchanged (age, projection, collimation, magnification). Three to five frames of DSA imparted an effective dose equal to doses from 1 minute of fluoroscopy. Doses from spin angiography were almost one-half the doses received from an equivalent number of frames of DSA.
Patient effective doses during interventional procedures vary substantially depending on procedure type but tend to be higher because of magnification use in younger children and higher in the abdomen.
本研究旨在确定介入放射学程序中使用的成像技术相关的有效剂量范围。
使用儿童体模套件(1 岁、5 岁和 10 岁)和高灵敏度金属氧化物半导体场效应晶体管(MOSFET)剂量计来计算有效剂量。将 20 个 MOSFET 插入每个体模的敏感器官位置。将体模暴露于不同几何形状和放大倍数的模拟头、胸和腹部介入放射学程序中。在每个体模上模拟透视、数字减影血管造影(DSA)和自旋血管造影。仅在 5 岁体模上进行道路映射。将 MOSFET 记录的器官剂量应用于国际辐射防护委员会第 103 号出版物中的组织权重,以确定有效剂量。为便于临床应用,将剂量归一化为透视每分钟和 DSA 或自旋血管造影每 10 帧。
由于使用了放大倍数,年龄较小的儿童接受的 DSA、血管造影和透视的有效剂量更高,腹部手术的剂量最大。头部、胸部和腹部 DSA(归一化为每 10 帧)的剂量比透视每分钟相应剂量高 2-3 倍,而其他所有因素保持不变(年龄、投影、准直、放大倍数)。3-5 帧 DSA 的有效剂量与 1 分钟透视的剂量相当。自旋血管造影的剂量几乎是同等帧数 DSA 剂量的一半。
介入程序中患者的有效剂量因程序类型而有很大差异,但由于在年幼儿童中使用放大倍数以及在腹部更高,因此趋于更高。