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操作者位置、高度和身体方向对介入放射学和心脏病学中晶状体剂量的影响:蒙特卡罗模拟与现实临床测量的比较。

The influence of operator position, height and body orientation on eye lens dose in interventional radiology and cardiology: Monte Carlo simulations versus realistic clinical measurements.

机构信息

Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya, Avda. Diagonal, 647, 08028 Barcelona, Spain.

IRSN - Institut de Radioprotection et de Sûreté Nucléaire, BP-17, 92262 Fontenay-aux-Roses, France.

出版信息

Phys Med. 2016 Sep;32(9):1111-7. doi: 10.1016/j.ejmp.2016.08.010. Epub 2016 Aug 20.

DOI:10.1016/j.ejmp.2016.08.010
PMID:27554367
Abstract

OBJECTIVE

This paper aims to provide some practical recommendations to reduce eye lens dose for workers exposed to X-rays in interventional cardiology and radiology and also to propose an eye lens correction factor when lead glasses are used.

METHODS

Monte Carlo simulations are used to study the variation of eye lens exposure with operator position, height and body orientation with respect to the patient and the X-ray tube. The paper also looks into the efficiency of wraparound lead glasses using simulations. Computation results are compared with experimental measurements performed in Spanish hospitals using eye lens dosemeters as well as with data from available literature.

RESULTS

Simulations showed that left eye exposure is generally higher than the right eye, when the operator stands on the right side of the patient. Operator height can induce a strong dose decrease by up to a factor of 2 for the left eye for 10-cm-taller operators. Body rotation of the operator away from the tube by 45°-60° reduces eye exposure by a factor of 2. The calculation-based correction factor of 0.3 for wraparound type lead glasses was found to agree reasonably well with experimental data.

CONCLUSIONS

Simple precautions, such as the positioning of the image screen away from the X-ray source, lead to a significant reduction of the eye lens dose. Measurements and simulations performed in this work also show that a general eye lens correction factor of 0.5 can be used when lead glasses are worn regardless of operator position, height and body orientation.

摘要

目的

本文旨在为减少介入心脏病学和放射学中 X 射线照射工作人员晶状体剂量提供一些实用建议,并提出使用铅眼镜时的晶状体校正因子。

方法

采用蒙特卡罗模拟方法研究了操作人员位置、高度和相对于患者及 X 射线管的身体方位对晶状体照射的影响。本文还研究了全包式铅眼镜的效率。计算结果与西班牙医院使用晶状体剂量计进行的实验测量以及现有文献中的数据进行了比较。

结果

模拟结果表明,当操作人员站在患者右侧时,左眼的暴露通常高于右眼。操作人员的高度可导致左眼剂量显著降低,最高可达 2 倍,对于高 10 厘米的操作人员。操作人员向管体旋转 45°-60°可使眼部照射降低 2 倍。发现基于计算的全包式铅眼镜校正因子为 0.3,与实验数据吻合较好。

结论

简单的预防措施,如将影像屏远离 X 射线源放置,可显著降低晶状体剂量。本工作中的测量和模拟还表明,当佩戴铅眼镜时,无论操作人员的位置、高度和身体方位如何,都可以使用通用的晶状体校正因子 0.5。

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