Imaging and Functional Medicine, Region Dalarna, Falun, Sweden.
Department of Internal Medicine, Falu Hospital, Falun, Sweden.
Acta Radiol. 2022 Jan;63(1):11-21. doi: 10.1177/0284185120983281. Epub 2020 Dec 26.
The radiation dose to staff performing endoscopic retrograde cholangiopancreatography (ERCP) is not negligible.
To evaluate the shielding effect of a table-suspended lower-body radiation shield for the positions in the room occupied by the operator, assisting nurse, and anesthesiologist, used during ERCP procedures with a mobile C-arm.
Eye lens dose, whole body dose, and extremity dose were measured with and without a table-suspended lower-body radiation shield in a phantom model and in clinical routine work. The effect of the shield was evaluated for each scenario and compared, and a projection was made for when shielding should be required from a regulatory point of view.
In the phantom measurements, the shield provided significant shielding effects on the body and lower extremities for the operator but no significant shielding of the eye lens. The shielding effect for the assisting nurse was limited to the lower extremity. The clinical measurements yielded the same general result as the phantom measurements, with the major difference that the shield provided no significant reduction in the whole-body dose to the operator.
The table-suspended shield has a significant shielding effect for the lower extremities of the operator and assisting nurse. For annual dose-area product values >300,000 cGycm, the protection of the operator should be reinforced with a ceiling-suspended shield to avoid doses to the eye lens and body in excess of regulatory dose restrictions.
行内镜逆行胰胆管造影术(ERCP)的医护人员所受的辐射剂量不可忽视。
评估在使用移动 C 臂进行 ERCP 时,操作者、助手护士和麻醉师所处位置的桌悬式下半身辐射屏蔽的屏蔽效果。
在体模和临床常规工作中,测量并比较有和没有桌悬式下半身辐射屏蔽时的晶状体剂量、全身剂量和肢体剂量。评估并比较每个场景下的屏蔽效果,并从监管角度预测何时需要屏蔽。
在体模测量中,屏蔽器为操作者的身体和下肢提供了显著的屏蔽效果,但对晶状体没有显著的屏蔽效果。对助手护士的屏蔽效果仅限于下肢。临床测量得出的结果与体模测量基本相同,主要区别在于屏蔽器对操作者的全身剂量没有显著降低。
桌悬式屏蔽器对操作者和助手护士的下肢有显著的屏蔽效果。对于年剂量面积产品值>300000 cGycm,应使用天花板悬挂式屏蔽器加强对操作者的保护,以避免晶状体和身体受到超过监管剂量限制的剂量。