Machan Lindsay
Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
Tech Vasc Interv Radiol. 2018 Mar;21(1):21-25. doi: 10.1053/j.tvir.2017.12.005. Epub 2017 Dec 16.
The ocular lens is one of the most susceptible structures in the body to radiation damage. Unfortunately, much of the traditional academic and regulatory thinking on thresholds to develop radiation-induced opacities or cataracts has proven to be false. Individual vulnerability to the effects of radiation is extremely variable, largely because each individual is variably genetically equipped to repair the damage caused by radiation. Therefore many people, including some unsuspecting interventional radiologists may have no, or almost no, threshold at all for cataract development after radiation injury. For most others, if there is a threshold it is a fraction of what was previously thought. These new data have become apparent during the same time period when unprecedented numbers of physicians and medical staff have been exposed to unprecedented doses of scatter radiation as the number and complexity of fluoroscopic guided procedures has exploded. Increased rates of radiation lens damage have already been documented in physicians and support staff working in interventional medicine. As there is a latency period of years to decades for lens injury to fully evolve it is quite possible the true incidence will not be known for some time. Strategies to minimize the potential risks encountered in interventional medicine include radiation safety best practices, passive and personal barrier protection, and philosophical approach to interventional radiology practice. Ignore this article at your peril.
眼晶状体是人体中对辐射损伤最敏感的结构之一。不幸的是,许多关于辐射诱发混浊或白内障阈值的传统学术和监管观点已被证明是错误的。个体对辐射影响的易感性差异极大,很大程度上是因为每个人修复辐射造成损伤的基因能力各不相同。因此,许多人,包括一些毫无戒心的介入放射科医生,在辐射损伤后可能根本没有或几乎没有白内障发展的阈值。对大多数其他人来说,如果存在阈值,也只是之前所认为的一小部分。在同一时期,随着透视引导手术的数量和复杂性激增,前所未有的大量医生和医护人员受到了前所未有的散射辐射剂量,这些新数据变得明显起来。在介入医学工作的医生和辅助人员中,辐射性晶状体损伤的发生率已经有所记录。由于晶状体损伤完全显现需要数年至数十年的潜伏期,在一段时间内很可能无法得知真实发病率。将介入医学中潜在风险降至最低的策略包括辐射安全最佳实践、被动和个人屏障防护以及介入放射学实践的理念。忽视本文将自担风险。