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介入放射学环境中患者的辐射防护:一项系统评价

Patients' Radiation Shielding in Interventional Radiology Settings: A Systematic Review.

作者信息

El-Diasty Mohamed T, Olfat Ahmed A, Mufti Ahmad S, Alqurashi Ahmed R, Alghamdi Mohammed J

机构信息

Department of Radiology, King Abdulaziz University Hospital, Jeddah, SAU.

Department of Radiology, King Abdullah Medical City, Mecca, SAU.

出版信息

Cureus. 2021 Aug 4;13(8):e16870. doi: 10.7759/cureus.16870. eCollection 2021 Aug.

DOI:10.7759/cureus.16870
PMID:34513445
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8412000/
Abstract

As a result of the increasing risk of developing radiation-related complications, many approaches aimed at reducing this risk and enhancing the outcomes of the patient, doctor or device operator have been developed. In this systematic review, we aim to discuss previous investigations that studied patient shielding or protection within the context of selected interventional radiology procedures. We included original studies that used K and P for the assessment of the outcomes of two procedures: transjugular intrahepatic portosystemic shunt creation (TIPS) and hepatic arterial chemoembolization (HAE). A thorough search strategy was conducted on relevant databases to identify all relevant studies. We included 13 investigations, including 12 cross-sectional studies and one randomized controlled trial. Significant diversity was found among all these studies in terms of the used modalities, which made them hard to compare. However, almost all studies agreed that using novel imaging and interventional modalities is useful when obtaining better outcomes and reducing patient radiation exposure. The use of ultrasound-guided procedures and providing adequate lead curtains has also been recommended by the identified studies in order to minimize the frequency of radiation exposure. The reported K and P were also variable between studies and were discussed within this study. Our findings indicate that unified guidelines for patient radiation shielding should be urgently investigated.

摘要

由于发生辐射相关并发症的风险不断增加,人们已开发出许多旨在降低这种风险并改善患者、医生或设备操作员治疗效果的方法。在本系统评价中,我们旨在讨论先前在选定的介入放射学程序背景下研究患者屏蔽或防护的调查。我们纳入了使用K和P评估两种程序结果的原始研究:经颈静脉肝内门体分流术(TIPS)和肝动脉化疗栓塞术(HAE)。对相关数据库进行了全面的检索策略,以识别所有相关研究。我们纳入了13项调查,包括12项横断面研究和1项随机对照试验。在所有这些研究中,所用模式存在显著差异,这使得它们难以比较。然而,几乎所有研究都一致认为,使用新型成像和介入模式在获得更好的治疗效果和减少患者辐射暴露方面是有用的。已识别的研究还建议使用超声引导程序并提供足够的铅帘,以尽量减少辐射暴露的频率。各研究报告的K和P也各不相同,并在本研究中进行了讨论。我们的研究结果表明,应迫切研究针对患者辐射屏蔽的统一指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af2f/8412000/abe32a20aca0/cureus-0013-00000016870-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af2f/8412000/abe32a20aca0/cureus-0013-00000016870-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af2f/8412000/abe32a20aca0/cureus-0013-00000016870-i01.jpg

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本文引用的文献

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An initial investigation of a wireless patient radiation dosimeter for use in interventional radiology.初步研究用于介入放射学的无线患者辐射剂量计。
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Patient Radiation Dose Reduction Considerations in a Contemporary Interventional Radiology Suite.当代介入放射学手术室中患者辐射剂量降低的考量因素
Cardiovasc Intervent Radiol. 2018 Dec;41(12):1925-1934. doi: 10.1007/s00270-018-2052-7. Epub 2018 Aug 21.
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Benchmarking the DACS-integrated Radiation Dose Monitor® skin dose mapping software using XR-RV3 Gafchromic® films.使用 XR-RV3 型 Gafchromic®胶片对 DACS 集成的辐射剂量监测仪®皮肤剂量测绘软件进行基准测试。
Med Phys. 2018 Oct;45(10):4683-4692. doi: 10.1002/mp.13125. Epub 2018 Aug 31.
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Contemporary Interventional Radiology Dosimetry: Analysis of 4,784 Discrete Procedures at a Single Institution.当代介入放射医学剂量学:单机构 4784 项离散操作分析。
J Am Coll Radiol. 2018 Sep;15(9):1214-1221. doi: 10.1016/j.jacr.2018.06.004. Epub 2018 Jul 3.
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Fast skin dose estimation system for interventional radiology.用于介入放射学的快速皮肤剂量估算系统。
J Radiat Res. 2018 Mar 1;59(2):233-239. doi: 10.1093/jrr/rrx062.
9
Use of transabdominal ultrasound-guided transjugular portal vein puncture on radiation dose in transjugular intrahepatic portosystemic shunt formation.经腹超声引导下经颈静脉门静脉穿刺在经颈静脉肝内门体分流术形成中的辐射剂量应用。
Diagn Interv Radiol. 2017 May-Jun;23(3):206-210. doi: 10.5152/dir.2016.15601.
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Radiation dose reduction during transjugular intrahepatic portosystemic shunt implantation using a new imaging technology.使用一种新的成像技术在经颈静脉肝内门体分流术植入过程中降低辐射剂量。
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