Pasciak A, Neveu M, Sriharan A, Balius A, Jones A
University of Tennessee Medical Center, Knoxville, TN.
The University of Tennessee Medical School.
Med Phys. 2012 Jun;39(6Part4):3632. doi: 10.1118/1.4734747.
Sterile radiation reduction gloves have been widely used in the past decade to provide modest decreases in operator hand dose when the hands are placed in the field of view (FOV). While multiple publications have quantified the potential dose reduction from the use of such gloves, possible effects on the patient have not yet been assessed. The aim of this study was to determine if radiation reduction gloves can Result in a significant increase in patient dose and increased risk of radiation induced skin injury when used in interventional radiology.
The effect of radiation reduction gloves when used in the FOV was determined by measurement of patient entrance exposure rate (EER) for a variety of patient sizes and varying operating and magnification modes. EERs were measured with no glove in the FOV, with one glove and, to replicate the actions of many dose-conscious radiologists, with double gloves in the FOV.
Compared to an ungloved hand, the use of a single radiation reduction glove near the center of the FOV results in a 2-fold average increase in patient EER. The use of double radiation reduction gloves results in a 3-fold average increase in EER. In both cases, this increase was only weakly dependent on the size of the patient and on the operating and magnification modes used. In fact, patient thicknesses ranging from 6-14 inches and operating modes ranging from low-dose fluoroscopy to DSA produced less than a 20% deviation from the increases in EER quoted above.
When used in the FOV, radiation reduction gloves can substantially increase patient EER. This increase in patient dose, when compared with the relatively small published reduction in extremity dose provided to the operator, may make their use contraindicated in cases where radiation induced skin injury is a possible risk.
在过去十年中，无菌辐射防护手套已被广泛使用，当手部置于视野（FOV）中时，可适度降低操作者手部剂量。虽然有多项出版物对使用此类手套可能降低的剂量进行了量化，但尚未评估其对患者可能产生的影响。本研究的目的是确定在介入放射学中使用辐射防护手套是否会导致患者剂量显著增加以及辐射诱发皮肤损伤的风险增加。
通过测量各种患者体型以及不同操作和放大模式下患者的入射体表剂量率（EER），来确定辐射防护手套在视野中使用时的效果。分别测量视野中无手套、有一只手套以及为模拟许多注重剂量的放射科医生的操作而有两只手套时的EER。
与未戴手套的手相比，在视野中心附近使用一只辐射防护手套会使患者EER平均增加2倍。使用两只辐射防护手套会使EER平均增加3倍。在这两种情况下，这种增加仅微弱地依赖于患者体型以及所使用的操作和放大模式。事实上，患者厚度在6至14英寸之间以及操作模式从低剂量透视到数字减影血管造影（DSA）时，与上述EER增加量的偏差均小于20%。
当在视野中使用时，辐射防护手套会大幅增加患者EER。与已公布的为操作者提供的相对较小的肢体剂量降低相比，患者剂量的这种增加可能使得在存在辐射诱发皮肤损伤风险的情况下禁忌使用它们。
