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混合式血管造影磁共振检查室中的操作人员和患者的辐射防护。

Radiation protection of operators and patients in a hybrid Angio-MR suite.

机构信息

UZ Gasthuisberg, Department of Radiology, Herestraat 49, 3000 Leuven, Belgium.

UZ Gasthuisberg, Department of Radiology, Herestraat 49, 3000 Leuven, Belgium.

出版信息

Phys Med. 2020 Jun;74:143-154. doi: 10.1016/j.ejmp.2020.04.028. Epub 2020 May 27.

DOI:10.1016/j.ejmp.2020.04.028
PMID:32473413
Abstract

This work investigates the patient eye lens dose and x-ray scatter to the operator expected for a proposed hybrid Angio-MR concept. Two geometries were simulated for comparative assessment: a standard C-arm device for neuro-angiography applications and an innovative hybrid Angio-MR system concept, proposed by Siemens Healthineers. The latter concept is based on an over-couch x-ray tube and a detector inside an MRI system, with the aim of allowing combined, simultaneous MRI and x-ray imaging for procedures such as neurovascular interventions (including x-ray fluoroscopy and angiography imaging, 3D imaging, diffusion, and perfusion). To calculate the scattered radiation dose to the physician, Monte Carlo simulations were performed. Dose estimates of simplified models of the brain and eyes of both the patient and the physician and of the physician's torso and legs have been calculated. A number of parameters were varied in the simulation including x-ray spectrum, field of view (FOV), x-ray tube angulation, presence of shielding material and position of the physician. Additionally, 3D dose distributions were calculated in the vertical and horizontal planes in both setups. The patient eye lens dose was also calculated using a detailed voxel phantom and measured by means of thermoluminescent dosimeters (TLDs) to obtain a more accurate estimate. Assuming the same number of x-rays and the same size of the irradiated area on the patient's head, the results show a significant decrease in the scattered radiation to the physician for the Angio-MR system, while large increases, depending on setup, are expected to patient eye lens dose.

摘要

本研究旨在探讨拟议的混合式 Angio-MR 概念中患者晶状体剂量和 X 射线散射到操作人员的预期情况。为了进行比较评估,模拟了两种几何结构:一种是用于神经血管造影应用的标准 C 臂设备,另一种是西门子健康公司提出的创新混合式 Angio-MR 系统概念。后者的概念基于一个位于 MRI 系统内的过顶 X 射线管和探测器,旨在允许同时进行 MRI 和 X 射线成像,用于神经血管介入等程序(包括 X 射线透视和血管造影成像、3D 成像、扩散和灌注)。为了计算散射辐射剂量,进行了蒙特卡罗模拟。计算了简化的患者和医生的大脑和眼睛模型以及医生的躯干和腿部的剂量估算,并在模拟中改变了许多参数,包括 X 射线光谱、视野(FOV)、X 射线管角度、屏蔽材料的存在以及医生的位置。此外,还在两种设置中计算了垂直和水平平面的 3D 剂量分布。还使用详细的体素模型计算了患者晶状体剂量,并通过热释光剂量计(TLDs)进行了测量,以获得更准确的估计。假设 X 射线数量相同且患者头部受照面积相同,结果表明 Angio-MR 系统中医生的散射辐射显著减少,而患者晶状体剂量预计会大幅增加,具体取决于设置。

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