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手外科手术与荧光透视眼部辐射剂量:大型与小型C型臂荧光透视使用的前瞻性初步比较

Hand Surgery and Fluoroscopic Eye Radiation Dosage: A Prospective Pilot Comparison of Large Versus Mini C-Arm Fluoroscopy Use.

作者信息

Wang Mark L, Hoffler C Edward, Ilyas Asif M, Kirkpatrick William H, Beredjiklian Pedro K, Leinberry Charles F

机构信息

Thomas Jefferson University, Philadelphia, PA, USA.

出版信息

Hand (N Y). 2017 Jan;12(1):21-25. doi: 10.1177/1558944716643279. Epub 2016 Apr 6.

Abstract

The purpose of this study is to (1) perform a prospective pilot comparison of the impact of large versus mini C-arm fluoroscopy on resultant eye radiation exposure and (2) test the hypothesis that the use of either modality during routine hand surgery does not exceed the current recommended limits to critical eye radiation dosage. Over a 12-month period, eye radiation exposure was prospectively measured by a board-certified hand surgeon using both large and mini C-arm fluoroscopy. For each modality, accumulated eye radiation dosage was measured monthly, while fluoroscopic radiation output was recorded, including total exposure time and dose rate. A total of 58 cases were recorded using large C-arm and 25 cases using mini C-arm. Between the 2 groups, there was not a significant difference with total exposure time ( = .88) and average dose rate per case ( = .10). With the use of either modality, average monthly eye radiation exposure fell within the undetectable range (<30 mrem), significantly less than the current recommended limit of critical eye radiation (167 mrem/month). The impact of various fluoroscopic sources on eye radiation exposure remains relatively unexplored. In this study, the minimal detectable eye radiation dosages observed in both groups were reliably consistent. Our findings suggest that accumulated eye radiation dosage, from the use of either fluoroscopic modality, does not approach previously reported levels of critical radiation loads.

摘要

本研究的目的是

(1)对大型C形臂荧光透视与小型C形臂荧光透视对眼部辐射暴露的影响进行前瞻性初步比较;(2)检验在常规手部手术中使用这两种方式时,眼部辐射剂量均未超过当前推荐的临界辐射剂量限值这一假设。在12个月的时间里,由一名获得委员会认证的手外科医生使用大型和小型C形臂荧光透视前瞻性地测量眼部辐射暴露情况。对于每种方式,每月测量累积眼部辐射剂量,同时记录荧光透视辐射输出,包括总暴露时间和剂量率。使用大型C形臂记录了58例病例,使用小型C形臂记录了25例病例。两组之间,总暴露时间(P = 0.88)和每例平均剂量率(P = 0.10)没有显著差异。使用这两种方式时,平均每月眼部辐射暴露均处于检测不到的范围内(<30毫雷姆),显著低于当前推荐的临界眼部辐射限值(167毫雷姆/月)。各种荧光透视源对眼部辐射暴露的影响仍相对未被探索。在本研究中,两组观察到的最小可检测眼部辐射剂量可靠地一致。我们的研究结果表明,使用任何一种荧光透视方式时,累积眼部辐射剂量均未达到先前报道的临界辐射负荷水平。

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