Thomas Rohit Philip, Grau Mathias, Eldergash Osama, Kowald Tobias, Schnabel Johannes, Szczechowicz Marcin, Chavan Ajay
Institute of Diagnostic and Interventional Radiology, Klinikum Oldenburg AöR, Rahel Straus Straße 10, 26133, Oldenburg, Germany.
Department of Cardiac Surgery, University Hospital, Klinikum Oldenburg AöR, Oldenburg, Germany.
Cardiovasc Intervent Radiol. 2018 Jul;41(7):1074-1080. doi: 10.1007/s00270-018-1960-x. Epub 2018 Apr 23.
The annual permissible radiation ocular lens dose has been reduced to 20 millisieverts (mSv) in the current European directive 2013/59/Euratom. The aim of this study was to evaluate the personal radiation dose for vascular interventions with special focus on ocular lens dose.
From May 2016 to October 2016, the personal radiation doses of two interventionists and four technicians were prospectively recorded during 206 vascular interventions. The position of personnel, intervention type and fluoroscopy time were recorded. Parameters evaluated were total body dose measured by film dosimeter, hand dose measured by ring thermoluminescent dosimeter (TLD) and ocular lens dose measured by TLD placed in front of the safety glasses. Linear regression analysis was used to estimate the dose at 2 and 5 years.
The ocular lens dose, hand and total body dose of the two interventionists were 11/5, 56/47 and 0.6 mSv each, respectively. The estimated 5-year ocular dose was 113.08 mSv (95% CI 38.2-187.97)/40.95 (95% CI 16.9-64.7). Similarly, hand dose was 608.4 mSv (95% CI 442.78-774.38)/514.47 (95% CI 329.83-699.10) and body dose 6.07 mSv (95% CI 4.70-8.22)/5.12 (95% CI 3.65-6.59), respectively. Amongst four technicians, only the first assistant showed recordings of 0.3 mSv body dose, 2 mSv ocular lens dose and 5 mSv hand dose.
The yearly ocular lens dose, particularly for interventionists dealing with complex interventions, could cross the permitted yearly limit set by the new Euratom directive. Therefore, X-ray safety glasses would become mandatory for complex radiological vascular interventions.
Level III, non-randomized controlled cohort/follow-up study.
在当前的欧洲指令2013/59/Euratom中，眼部晶状体的年度允许辐射剂量已降至20毫希沃特（mSv）。本研究的目的是评估血管介入手术中的个人辐射剂量，特别关注眼部晶状体剂量。
2016年5月至2016年10月，在206例血管介入手术期间前瞻性记录了两名介入医生和四名技术人员的个人辐射剂量。记录人员位置、介入类型和透视时间。评估的参数包括用胶片剂量计测量的全身剂量、用环形热释光剂量计（TLD）测量的手部剂量以及置于安全眼镜前方的TLD测量的眼部晶状体剂量。采用线性回归分析估计2年和5年时的剂量。
两名介入医生的眼部晶状体剂量、手部剂量和全身剂量分别为11/5、56/47和0.6 mSv。估计的5年眼部剂量为113.08 mSv（95%CI 38.2 - 187.97）/40.95（95%CI 16.9 - 64.7）。同样，手部剂量为608.4 mSv（95%CI 442.78 - 774.38）/514.47（95%CI 329.83 - 699.10），全身剂量为6.07 mSv（95%CI 4.70 - 8.22）/5.12（95%CI 3.65 - 6.59）。在四名技术人员中，只有第一助手记录有0.3 mSv的全身剂量、2 mSv的眼部晶状体剂量和5 mSv的手部剂量。
眼部晶状体的年度剂量，特别是对于进行复杂介入手术的介入医生，可能会超过新的Euratom指令设定的年度允许限值。因此，对于复杂的放射学血管介入手术，X射线安全眼镜将成为强制性要求。
III级，非随机对照队列/随访研究。
