Karami Vahid, Zabihzadeh Mansour, Shams Nasim, Saki Malehi Amal
Department of Medical Physics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2)Department of Medical Physics, Student Research Committee, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 3)Department of Clinical Oncology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz.
Arch Iran Med. 2017 Feb 1;20(2):113-123.
Gonad shielding has been extensively advocated during pelvic radiography at or below reproductive ages. The popular practice of gonad shielding is placement of a lead shield in the midline of the pelvis. The aim of this study was to address the prevalence of gonad shielding and find out whether the current practice of gonad shielding can be considered as an effective method to reduce radiation exposure in patients undergoing pelvic radiography.
National and international electronic databases, including PubMed, MEDLIN, EMBASE, and Google-Scholar, were searched up to January 2016. The database searches were supplemented with manual searches of reference lists. Two authors independently assessed the eligibility of all studies and extracted data.
The searches yielded a total of 243 publications. After assessing each identified study against specific inclusion exclusion criteria, 18 studies were deemed as relevant for this review. The total prevalence rate of gonad shielding was estimated at 58% (95% CI: 40 to 74%). It was estimated that only 34% (95% CI: 25 to 44%) of the radiographs had correct positioning of the shield. Also, incorrect positioning of the shield was statistically significantly higher in females than males (85% vs. 52 %; P-value < 0.001).
Our study demonstrates that the current practice of gonad shielding during female pelvic radiography should be no longer considered as an effective method to reduce radiation exposure. Training the best qualified radiographers is the key to accurate positioning of the shield in male subjects.
在对育龄期及以下人群进行骨盆X光检查时，性腺屏蔽已得到广泛提倡。性腺屏蔽的普遍做法是在骨盆中线放置铅屏蔽物。本研究的目的是探讨性腺屏蔽的普及率，并确定当前的性腺屏蔽做法是否可被视为减少骨盆X光检查患者辐射暴露的有效方法。
检索截至2016年1月的国内外电子数据库，包括PubMed、MEDLIN、EMBASE和谷歌学术。数据库检索辅以对参考文献列表的手动检索。两位作者独立评估所有研究的 eligibility 并提取数据。
检索共产生243篇出版物。根据特定的纳入排除标准对每项纳入研究进行评估后，18项研究被认为与本综述相关。性腺屏蔽的总普及率估计为58%（95%可信区间：40%至74%）。据估计，只有34%（95%可信区间：25%至44%）的X光片屏蔽物定位正确。此外，屏蔽物定位错误在女性中在统计学上显著高于男性（85%对52%；P值<0.001）。
我们的研究表明，在女性骨盆X光检查中当前的性腺屏蔽做法不应再被视为减少辐射暴露的有效方法。培训最合格的放射技师是男性受试者中屏蔽物准确定位的关键。
