Morishima Yoshiaki, Chida Koichi, Meguro Takayoshi
Department of Radiology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai 983-8512, Japan.
Department of Radiological Technology, Tohoku University School of Health Sciences, 2-1 Seiryo Aoba-ku, Sendai 980-8575, Japan.
J Radiat Res. 2018 Mar 1;59(2):225-232. doi: 10.1093/jrr/rrx039.
Endoscopic retrograde cholangiopancreatography (ERCP) is often complex and involves long fluoroscopic times, with significant radiation exposure to medical staff. We investigated protective effects of an additional attached lead shielding device. The lead shielding device covered with the X-ray tube table (0.125 mm lead equivalent) during ERCP procedures. Fluoroscopy scatter radiation, with or without the lead shielding device, was measured using an acrylic phantom and a radiation survey meter. Measurements (25 points) were made at 50 cm intervals, at both 90 and 150 cm above the floor. We created radiation maps, with and without the additional lead shielding device. Moreover, we monitored annual staff exposure to radiation, before and after inclusion of the shielding device. Without additional shielding, exposure doses at the physician's position, 90 and 150 cm above the floor, were 1940 and 4040 (μSv/h) respectively. In contrast, with the shielding device, corresponding exposures were 270 and 450 (μSv/h) at 90 and 150 cm, respectively. Scattered radiation was decreased by 86.1% at 90 cm or 88.9% at 150 cm. However, with additional lead shielding in the middle, rather than hung over the operating table, scattered radiation was decreased by only ~10%. The staff's annual dose equivalents (DEs) were 12.2-29.8 mSv/year without and 3.8-8.4 mSv/year with lead shielding. With lead shielding, dose equivalent values for the staff were decreased by 41.0-76.5%. Thus, with additional lead shielding, properly used, scattered radiation would be decreased by ~90%, thus decreasing exposure doses to medical staff during ERCPs.
内镜逆行胰胆管造影术（ERCP）通常较为复杂，且需要较长的透视时间，医护人员会受到大量辐射。我们研究了一种额外附加的铅屏蔽装置的防护效果。在ERCP手术过程中，铅屏蔽装置覆盖在X射线管检查台上（铅当量为0.125毫米）。使用丙烯酸体模和辐射测量仪测量有无铅屏蔽装置时的透视散射辐射。在离地面90厘米和150厘米处，每隔50厘米进行25个点的测量。我们绘制了有无额外铅屏蔽装置时的辐射图。此外，我们监测了在纳入屏蔽装置前后医护人员的年度辐射暴露情况。在没有额外屏蔽的情况下，在离地面90厘米和150厘米处医生位置的暴露剂量分别为1940和4040（微希沃特/小时）。相比之下，使用屏蔽装置时，在90厘米和150厘米处的相应暴露剂量分别为270和450（微希沃特/小时）。在90厘米处散射辐射减少了86.1%，在150厘米处减少了88.9%。然而，如果在中间添加额外的铅屏蔽，而不是挂在手术台上，散射辐射仅减少约10%。在没有铅屏蔽时，医护人员的年度剂量当量为12.2 - 29.8毫希沃特/年，有铅屏蔽时为3.8 - 8.4毫希沃特/年。有铅屏蔽时，医护人员的剂量当量值降低了41.0 - 76.5%。因此，正确使用额外的铅屏蔽，散射辐射可减少约90%，从而降低ERCP手术期间医护人员的暴露剂量。
