Candela-Juan Cristian, Ciraj-Bjelac Olivera, Sans Merce Marta, Dabin Jérémie, Faj Dario, Gallagher Aoife, de Las Heras Gala Hugo, Knežević Željka, Malchair Françoise, De Monte Francesca, Simantirakis George, Theodorakou Chrysoula
Centro Nacional de Dosimetría (CND), Instituto Nacional de Gestión Sanitaria, Valencia, Spain.
University of Belgrade, Vinca institute of Nuclear Sciences, Belgrade, Serbia.
Phys Med. 2021 Jun;86:44-56. doi: 10.1016/j.ejmp.2021.05.017. Epub 2021 May 27.
The use of patient contact-shielding has become a topic of intensive scientific debate. While it has been common practice during the last decades, some studies have questioned the efficiency of using such shielding while others have highlighted the inconsistencies in its application. The objective of this work is to review current recommendations and legislative documents on the use of out-of-field shielding in X-ray imaging, including those from national authorities and from international and national organisations and professional bodies. The review, performed within the framework of the activities of EURADOS Working Group 12, covers available recommendations on use of contact shielding in adult, pregnant and paediatric patients in general radiography, fluoroscopy, computed tomography, mammography and dental radiology. It includes a comprehensive search of 83 documents from 32 countries and 6 international organisations over the last 39 years. In general, using shielding is recommended only under two conditions: if it does not compromise the diagnostic task and the performance of the procedure and/or if it reassures the patient and comforters that they are appropriately protected against potentially harmful effects of radiation. There are very few specific regulatory requirements to use shielding in a particular imaging modality, although they may consider use of shielding either as part of good radiological practice or as requirements for availability of protective or ancillary tools, without further specification of their use. There is a wide variety of positions among documents that recommend out-of-field shielding, those that do not recommend it and those that are not specific. Therefore, evidence-based consensus is still needed to ensure best and consistent practice.
使用患者接触式防护已成为激烈科学辩论的主题。尽管在过去几十年中这一直是常见做法，但一些研究对使用此类防护的效率提出了质疑，而另一些研究则强调了其应用中的不一致性。这项工作的目的是回顾关于在X射线成像中使用场外防护的当前建议和立法文件，包括来自国家当局以及国际和国家组织及专业机构的相关文件。该综述在欧洲放射防护剂量学学会（EURADOS）第12工作组的活动框架内进行，涵盖了在普通放射摄影、透视、计算机断层扫描、乳腺摄影和牙科放射学中对成人、孕妇和儿童患者使用接触式防护的现有建议。它包括对过去39年来自32个国家和6个国际组织的83份文件进行全面检索。一般来说，仅在以下两种情况下建议使用防护：如果它不影响诊断任务和检查程序的执行，和/或如果它能让患者和陪护人员放心，他们得到了适当的保护，免受潜在的辐射有害影响。在特定成像模式下使用防护的具体监管要求非常少，尽管它们可能将使用防护视为良好放射实践的一部分或作为对防护或辅助工具可用性的要求，但没有进一步说明其使用方法。在建议使用场外防护的文件、不建议使用的文件和未明确说明的文件之间存在各种各样的立场。因此，仍需要基于证据的共识来确保最佳和一致的实践。
