Lee Jae-Eun, Kim Ju-Hyun, Lee Su-Jin, Kim Mingeon, Nam Tae-Woo, Kim Chul Hyun, Jung Tae-Du, Hwang Jong-Moon
Department of Rehabilitation Medicine, Kyungpook National University Hospital.
Graduate School of Public Health, Kyungpook National University.
Medicine (Baltimore). 2019 Nov;98(46):e17959. doi: 10.1097/MD.0000000000017959.
Observational phantom study.This study aimed to evaluate the radiation exposure dose of practitioner's hands when performing C-arm guided procedures and to determine the usefulness of our newly designed radiation shielding device.C-arm guided procedures including lumbar transforaminal epidural steroid injections (TFESIs) are commonly used for pain control induced by lumbar radiculopathy. The practitioner's hands are vulnerable to radiation exposure because of the long exposure time and short distance from the radiation resource. No studies to date have reported the cumulative exposure of the physician's hands according to location and exposure time.Using a chest phantom irradiated with X-rays under lumbar TFESI conditions, cumulative scatter radiation dose was measured at 36 points using a dosimeter. The measurements were checked at 1, 3, 5, 10 minutes of radiation exposure. The experiment was repeated using our newly designed shielding device.Significant radiation accumulation was observed in the field where the practitioner's hands might be placed during C-arm guided procedures. The further the distance from the radiation resource and the shorter the exposure time, the smaller was the cumulative radiation expose dose. The new shielding device showed an excellent shielding rate (66.0%-99.9%) when the dosimeter was within the shielding range. However, at some points, increased accumulated radiation exposure dose was observed, although the dosimeter was within the range of the shielding device.To reduce radiation exposure of the practitioner's hands when performing C-arm-guided procedures, the radiation exposure time should be decreased and a greater distance from the radiation resource should be maintained. When using our shielding device, placing the hand close to the device surface and minimizing the time using fluoroscopy minimized the radiation exposure of the hand.
观察性体模研究。本研究旨在评估在进行C形臂引导手术时术者手部的辐射暴露剂量，并确定我们新设计的辐射屏蔽装置的有效性。包括腰椎经椎间孔硬膜外类固醇注射（TFESI）在内的C形臂引导手术常用于控制腰椎神经根病引起的疼痛。由于暴露时间长且距离辐射源近，术者的手部易受辐射暴露。迄今为止，尚无研究报道医生手部根据位置和暴露时间的累积暴露情况。
在腰椎TFESI条件下，使用经X射线照射的胸部体模，用剂量计在36个点测量累积散射辐射剂量。在辐射暴露1、3、5、10分钟时检查测量结果。使用我们新设计的屏蔽装置重复该实验。
在C形臂引导手术过程中术者手部可能放置的区域观察到显著的辐射积累。距离辐射源越远且暴露时间越短，累积辐射暴露剂量越小。当剂量计在屏蔽范围内时，新的屏蔽装置显示出优异的屏蔽率（66.0%-99.9%）。然而，在某些点，尽管剂量计在屏蔽装置范围内，但仍观察到累积辐射暴露剂量增加。
为了在进行C形臂引导手术时减少术者手部的辐射暴露，应减少辐射暴露时间，并保持与辐射源的更大距离。使用我们的屏蔽装置时，将手靠近装置表面并尽量减少使用荧光透视的时间可使手部的辐射暴露最小化。
