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评估在神经介入透视程序和锥形束计算机断层扫描 (CBCT) 扫描中使用头侧铅挡时对晶状体的剂量减少。

Assessment of Eye Lens Dose Reduction When Using Lateral Lead Shields on the Patient's Head during Neurointerventional Fluoroscopic Procedures and Cone-beam Computed Tomography (CBCT) Scans.

机构信息

Department of Radiology, The State University of New York at Buffalo, Buffalo, NY.

出版信息

Health Phys. 2020 Sep;119(3):289-296. doi: 10.1097/HP.0000000000001232.

Abstract

The purpose of this study was to evaluate the effect of placing small lead shields on the temple region of the skull to reduce radiation dose to the lens of the eye during interventional fluoroscopically-guided procedures and cone-beam computed tomography (CBCT) scans of the head. EGSnrc Monte-Carlo code was used to determine the eye lens dose reduction when using lateral lead shields for single x-ray projections, CBCT scans with different protocols, and interventional neuroradiology procedures with the Zubal computational head phantom. A clinical C-Arm system was used to take radiographic projections and CBCT scans of anthropomorphic head phantoms without and with lead patches, and the images were compared to assess the effect of the shields. For single lateral projections, a 0.1 (0.3)-mm-thick lead patch reduced the dose to the left-eye lens by 40% to 60% (55% to 80%) from 45° to 90° RAO and to the right-eye lens by around 30% (55%) from 70° to 90° RAO. For different CBCT protocols, the reduction of lens dose with a 0.3-mm-thick lead patch ranged from 20% to 53% at 110 kVp. For CBCT scans of the anthropomorphic phantom, the lead patch introduced streak artifacts that were mainly in the orbital regions but were insignificant in the brain region where most neurointerventional activity occurs. The dose to the patient's eye lens can be reduced considerably by placing small lead shields over the temple region of the head without substantially compromising image quality in neuro-imaging procedures.

摘要

本研究旨在评估在介入性荧光透视引导下的头部手术和锥形束 CT(CBCT)扫描期间,将小铅屏蔽物放置在颅骨太阳穴区域以减少眼部晶状体剂量的效果。使用 EGSnrc 蒙特卡罗代码来确定在使用侧向铅屏蔽物进行单次 X 射线投影、不同协议的 CBCT 扫描和使用 Zubal 计算头颅模型的介入神经放射学程序时,眼部晶状体剂量的减少。使用临床 C 臂系统对无和有铅贴片的人体头颅模型进行放射投影和 CBCT 扫描,并对图像进行比较以评估屏蔽物的效果。对于单次侧向投影,0.1(0.3)mm 厚的铅贴片将左眼晶状体的剂量从 45°到 90° RAO 减少了 40%到 60%(55%到 80%),从 70°到 90° RAO 减少了约 30%(55%)。对于不同的 CBCT 协议,0.3mm 厚的铅贴片将晶状体剂量减少了 20%到 53%,在 110 kVp 时。对于人体头颅模型的 CBCT 扫描,铅贴片引入了条纹伪影,主要在眼眶区域,但在大多数神经介入活动发生的大脑区域并不明显。通过在头部太阳穴区域放置小铅屏蔽物,可以大大减少患者眼部晶状体的剂量,而不会对神经成像程序的图像质量产生重大影响。

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