Kamusella Peter, Scheer Fabian, Lüdtke Christopher Wilhelm, Wiggermann Philipp, Wissgott Christian, Andresen Reimer
Consultant, Institute of Radiology, Roentgenpraxis Heide, Heide, Germany.
Consultant, Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westküstenklinikum Heide - Academic Teaching Hospital of the Universities of Kiel, Lübeck and Hamburg, Heide, Germany.
J Clin Diagn Res. 2017 Jul;11(7):TC26-TC29. doi: 10.7860/JCDR/2017/25226.10305. Epub 2017 Jul 1.
The radiation exposure to unprotected parts of the body requires special attention for the interventional radiologist. During angiographic procedures, hands are exposed to the direct X-ray beam and scattered radiation.
The aim of the study was to evaluate the radiation exposure of examiners hand with the use of lead-free X-ray protective gloves in clinical practice in terms of shielding and sense of touch. The aim of the study was to evaluate the radiation exposure of examiners hand with the use of lead-free X-ray protective gloves in clinical practice in terms of shielding and sense of touch.
Phantom measurements were conducted in the direct X-ray beam and the area of scattered radiation with and without shielding. Examiner measurements were determined in interventional angiographies in clinical routine of the lower limb in antegrade puncture technique through the femoral artery. In 24 out of 50 interventions, an elastic natural rubber latex glove with lead-free metal shielding against radiation was used. All measurements were performed with a direct dosimeter. After the intervention, an opinion of the examiner was requested for evaluation of the sense of touch.
Phantom measurements; when using the protective glove in the direct X-ray beam, a significant increase of the Dose Area Product (DAP) (1084.2-1603.8 mGycm; 67.6%; p<0.001) as well of the examiner's hand dose (143-221.8 μSv; 64.5%; p<0.001) was observed. A significant reduction of the examiner's hand dose was verifiable for scattered radiation (1.76-0.75 μSv; 42.6%; p<0.001). Examiner measurements; if protective gloves were used, a significant increase of the DAP (6183.2-10462.9 mGycm; 59.1%; p<0.05) and decrease of the average dose rate (0.76-0.43 mSv/h; 56.6%) for the entire procedure was determined. The tactile sensitivity was assessed as not restricted (18/24).
The new generation of protective gloves is characterized by a shielding effect against X-ray scattered radiation, without restricting the sense of touch. A significant reduction in radiation doses to the examiner can be accomplished with these gloves in the area of scattered radiation only. If the gloves were used in the direct X-ray beam, especially while the artery puncture was performed, a significant increase of the dose values was observed.
介入放射科医生需要特别关注身体未受保护部位所受到的辐射。在血管造影过程中，手部会暴露于直接X射线束和散射辐射中。
本研究的目的是在临床实践中，从屏蔽和触觉方面评估使用无铅X射线防护手套时检查者手部的辐射暴露情况。本研究的目的是在临床实践中，从屏蔽和触觉方面评估使用无铅X射线防护手套时检查者手部的辐射暴露情况。
在有屏蔽和无屏蔽的情况下，于直接X射线束和散射辐射区域进行模体测量。通过股动脉顺行穿刺技术，在下肢临床常规介入血管造影中确定检查者的测量值。在50例干预操作中的24例中，使用了带有无铅金属辐射屏蔽的弹性天然橡胶乳胶手套。所有测量均使用直接剂量仪进行。干预操作后，征求检查者对触觉的评价意见。
模体测量；在直接X射线束中使用防护手套时，剂量面积乘积（DAP）（1084.2 - 1603.8 mGycm；67.6%；p<0.001）以及检查者手部剂量（143 - 221.8 μSv；64.5%；p<0.001）均显著增加。对于散射辐射，可证实检查者手部剂量显著降低（1.76 - 0.75 μSv；42.6%；p<0.001）。检查者测量；如果使用防护手套，整个操作过程中DAP显著增加（6183.2 - 10462.9 mGycm；59.1%；p<0.05），平均剂量率降低（0.76 - 0.43 mSv/h；56.6%）。触觉敏感性评估为不受限制（18/24）。
新一代防护手套具有对X射线散射辐射的屏蔽作用，且不限制触觉。仅在散射辐射区域，使用这些手套可显著降低检查者所受的辐射剂量。如果在直接X射线束中使用手套，尤其是在进行动脉穿刺时，会观察到剂量值显著增加。
