Degiorgio Sarah, Gerasia Roberta, Liotta Ferdinanda, Maruzzelli Luigi, Cortis Kelvin, Miraglia Roberto, Luca Angelo
Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
Medical Imaging Department, Mater Dei Hospital, Triq Dun Karm, Birkirkara, Malta.
Cardiovasc Intervent Radiol. 2018 May;41(5):772-780. doi: 10.1007/s00270-017-1870-3. Epub 2018 Jan 17.
The primary aim of this study is to provide a summary of operators' radiation doses during hepatobiliary fluoroscopic guided procedures. In addition, patient dose in these procedures was also documented.
A total of 283 transarterial chemoembolisation (TACE) and 302 biliary procedures, including 52 percutaneous transhepatic cholangiogram (PTC), 36 bilioplasty and 214 biliary catheter changes (BCC) performed over 14 months, were included. Electronic personal dosimeters were used to measure operator radiation doses. Effective dose (E) was calculated using modified Niklason algorithm. Patient dose was measured as dose area product (DAP) and fluoroscopy time (FT).
For TACE, E for radiologist ranged between 0 and 9.96 µSv, for radiographer 0-0.99 µSv and for nurse 0-4.65 µSv. The patient DAP and FT ranged between 1.5 and 421.9 Gy cm and 1.91-67.25 min. For PTC, E for the radiologist ranged between 0.33 and 55.89 µSv, for radiographer 0-38.61 µSv and for nurse 0-3.18 µSv. Patient DAP and FT ranged between 1.7 and 218.4 Gy cm and 2.07-71.53 min. For bilioplasty, E ranged between 0.09 and 9.24 µSv for radiologist, 0-0.84 µSv for radiographer and 0-1.38 µSv for nurse. The patients' DAP and FT ranged from 0.7 to 52.54 Gy cm and 1.13-24.47 min. For BCC, E ranged from 0 to 12.78 µSv for radiologist, 0-8.43 µSv for radiographer and 0-4.05 µSv for nurse. Patient DAP and FT ranged between 0.12 and 117.3 Gy cm and 0.57-15.83 min.
This study shows that doses to all operators performing hepatobiliary interventional procedures can be very low.
本研究的主要目的是总结肝胆荧光透视引导手术过程中操作人员的辐射剂量。此外，还记录了这些手术中患者的剂量。
纳入了在14个月内进行的总共283例经动脉化疗栓塞术（TACE）和302例胆道手术，包括52例经皮肝穿刺胆管造影术（PTC）、36例胆管成形术和214例胆管导管更换术（BCC）。使用电子个人剂量计测量操作人员的辐射剂量。有效剂量（E）采用改良的尼克拉斯算法计算。患者剂量以剂量面积乘积（DAP）和透视时间（FT）来衡量。
对于TACE，放射科医生的E值范围为0至9.96微希沃特，放射技师为0至0.99微希沃特，护士为0至4.65微希沃特。患者的DAP和FT范围分别为1.5至421.9戈瑞·厘米和1.91至67.25分钟。对于PTC，放射科医生的E值范围为0.33至55.89微希沃特，放射技师为0至38.61微希沃特，护士为0至3.18微希沃特。患者的DAP和FT范围分别为1.7至218.4戈瑞·厘米和2.07至71.53分钟。对于胆管成形术，放射科医生的E值范围为0.09至9.24微希沃特，放射技师为0至0.84微希沃特，护士为0至1.38微希沃特。患者的DAP和FT范围分别为0.7至52.54戈瑞·厘米和1.13至24.47分钟。对于BCC，放射科医生的E值范围为0至12.78微希沃特，放射技师为0至8.43微希沃特，护士为0至4.05微希沃特。患者的DAP和FT范围分别为0.12至117.3戈瑞·厘米和0.57至15.83分钟。
本研究表明，所有进行肝胆介入手术操作人员的剂量可能非常低。
