Shanley C, Matthews K
Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
Radiography (Lond). 2018 Nov;24(4):328-333. doi: 10.1016/j.radi.2018.04.001. Epub 2018 Apr 30.
In projection radiography, lead rubber shielding has long been used to protect the gonads both within and outside the collimated field. However, the relative radio-sensitivity of the gonads is considered lower than previously, and doses from digital projection radiography are reported as being lower than in previous eras. These factors, along with technical difficulties encountered in placing lead shielding effectively, lead to varied opinions on the efficacy of such shielding in peer reviewed literature. This current study has investigated what is currently being taught as good practice concerning the use of lead shielding during projection radiography.
An online questionnaire was distributed to a purposive sample of 44 radiography educators across 15 countries, with the aim of establishing radiography educators' opinions about patient lead shielding and its teaching.
From the 27 responding educators, 57% (n = 15) teach students to apply gonadal shielding across a range of radiographic examinations; only 22% (n = 6) do the same for the breast, despite respondents being aware that the breast has higher relative radio-sensitivity than the gonads. Radiation protection was the primary reason given for using shielding. Students are generally expected to apply patient lead shielding during assessments, although a small number of respondents report that students must justify whether or not to apply lead shielding. Educators generally held the opinion that no matter what they are taught, students are influenced by what they see radiographers do in clinical practice.
The current study has not found consensus in literature or in radiography educators' opinions concerning the use of patient lead shielding. Findings suggest that a large scale empirical study to establish a specific evidence base for the appropriate use of lead shielding across a range of projection radiography examinations would be useful.
在投影放射摄影中，铅橡胶屏蔽长期以来一直用于保护准直野内外的性腺。然而，现在认为性腺的相对放射敏感性低于以前，并且有报道称数字投影放射摄影的剂量低于以前的时代。这些因素，再加上有效放置铅屏蔽时遇到的技术困难，导致同行评审文献中对这种屏蔽效果的看法各不相同。本研究调查了目前在投影放射摄影中使用铅屏蔽的良好做法。
向15个国家的44名放射摄影教育工作者的目标样本发放了一份在线问卷，目的是了解放射摄影教育工作者对患者铅屏蔽及其教学的看法。
在27名回复的教育工作者中，57%（n = 15）教导学生在一系列放射检查中应用性腺屏蔽；尽管受访者知道乳房的相对放射敏感性高于性腺，但只有22%（n = 6）的人对乳房采取同样的做法。辐射防护是使用屏蔽的主要原因。在评估期间，通常期望学生应用患者铅屏蔽，尽管少数受访者报告说学生必须说明是否应用铅屏蔽的理由。教育工作者普遍认为，无论教给学生什么，学生都会受到他们在临床实践中看到放射技师所做事情的影响。
本研究在关于患者铅屏蔽使用的文献或放射摄影教育工作者的意见中未发现共识。研究结果表明，进行一项大规模实证研究，为在一系列投影放射摄影检查中适当使用铅屏蔽建立具体的证据基础将是有益的。
