New York Medical College at St. Joseph's University Medical Center, Paterson, NJ.
Icahn School of Medicine at Mount Sinai Medical Center, New York, NY.
J Vasc Surg. 2019 Jul;70(1):246-250. doi: 10.1016/j.jvs.2018.07.055. Epub 2018 Oct 3.
With the explosion of minimally invasive surgery, the use of fluoroscopy has significantly increased. Concurrently, there has been a demand for lighter weight aprons. The industry answered this call with the development of lightweight aprons. Our goal was to see whether lighter weight garments provide reduced protection.
Dry laboratory testing was performed in a standard X-ray room, using a standard fluoroscopy table and standard acrylic blocks. A commercial-grade pressurized ion chamber survey meter (Ludlum Model 9DP; Ludlum Measurements, Inc, Sweetwater, Tex) was used to detect gamma rays and X-rays above 25 keV. Nonlead aprons from several manufacturers were tested for scatter radiation penetration above the table at a fixed distance (3 feet) and compared with two standard 0.5-mm lead aprons of different manufacturers.
Scatter measurements were made at 60 kVp and 70 kVp for pure lead (0.5 mm), mixed, and nonlead protective garments. Scatter penetration for the nonlead blends and barium aprons was 292% and 258%, respectively, at 60 kVp compared with the pure lead apron. At the higher beam quality of 70 kVp, the scatter penetration was 214% and 233% for the blend and barium aprons, respectively, compared with the pure lead apron. Our measurements demonstrate a noticeable difference in scatter reduction between pure lead and nonlead garments. Pure barium aprons and nonlead aprons from certain companies demonstrated scatter penetration that is inconsistent with the 0.5 mm of lead equivalence as claimed on the label. In addition, there was an incidental finding of a handful of lightweight aprons with significant tears along the seams, leaving large gaps in protection. Our study also demonstrates that several companies rate their lightweight garments as 0.5 mm lead equivalent, when actually only a small area on the chest and abdomen where the garment overlapped was 0.5 mm, leaving the rest of the garment with half the protection at 0.25 mm.
Our reliance on protective lead garments to shield us from the biologic effects of radiation exposure and the inferiority of some lightweight garments necessitate a streamlining of the testing methods and transparency in data reporting by manufacturers.
随着微创技术的爆炸式发展，透视的使用显著增加。同时，人们对更轻的围裙的需求也在增加。为了满足这一需求，业界开发了轻型围裙。我们的目标是观察较轻的衣物是否能提供较低的保护。
在标准 X 射线室中进行了干式实验室测试，使用标准透视台和标准丙烯酸块。使用商用级加压离子室测量计（Ludlum Model 9DP；Ludlum Measurements，Inc.，Sweetwater，Tex）检测 25keV 以上的伽马射线和 X 射线。对来自几家制造商的非铅围裙进行了测试，以检测在固定距离（3 英尺）上方桌子处的散射辐射穿透情况，并与两个不同制造商的标准 0.5 毫米铅围裙进行了比较。
在 60kVp 和 70kVp 下对纯铅（0.5mm）、混合和非铅防护衣进行了散射测量。与纯铅围裙相比，非铅混合物和钡围裙的散射穿透率分别为 60kVp 时的 292%和 258%。在更高的束质 70kVp 下，混合物和钡围裙的散射穿透率分别为 214%和 233%，与纯铅围裙相比。我们的测量结果表明，纯铅和非铅衣物在散射减少方面有明显差异。某些公司的纯钡围裙和非铅围裙的散射穿透率与标签上声称的 0.5 毫米铅当量不一致。此外，我们还偶然发现了一些轻便围裙，它们的缝线处有明显的撕裂，导致保护面积出现大的缺口。我们的研究还表明，几家公司将其轻便服装评为 0.5 毫米铅当量，但实际上只有胸部和腹部重叠的小面积为 0.5 毫米，其余部分的防护能力减半为 0.25 毫米。
我们依赖防护铅衣来保护我们免受辐射生物效应的影响，而一些轻便衣物的质量较差，这就需要制造商简化测试方法，并提高数据报告的透明度。
