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新型介入放射医师头部防护系统的临床评估。

Clinical evaluation of a novel head protection system for interventional radiologists.

机构信息

Klinikum Dortmund gGmbH, Department of Medical Physics and Radiation Protection, Beurhausstr. 40, 44137 Dortmund, Germany; University of Witten/Herdecke, Faculty for Health, Alfred-Herrhausen-Straße 50, 58455 Witten, Germany.

Materialprüfungsamt NRW, Department of Dosimetry, Marsbruchstr. 186, 44287 Dortmund, Germany.

出版信息

Eur J Radiol. 2022 Feb;147:110114. doi: 10.1016/j.ejrad.2021.110114. Epub 2021 Dec 22.

Abstract

PURPOSE

A novel two-part protective system consisting of a modified thyroid collar and a head protection is intended to reduce the radiation dose to the examiners head during fluoroscopy-guided interventions. In this pilot study, we tested this protection system under real-life conditions in general radiological and neuroradiological interventions.

METHODS

Two sets of the protection system (set A and B) were equipped with 12 thermoluminiscence detectors (TLD). For simultaneous measurement of radiation exposure and dose-reduction, each six TLDs were fixed to the inner side and on the corresponding outer side of the protection system. Set A was used exclusively for general radiological interventions and set B exclusively for neuroradiological interventions. To compare the staff exposure in general radiology and neuroradiology, dose values were normalized to a DAP of 10 000 µGy∙m.

RESULTS

The sets were tested during 20 general radiological interventions and 32 neuroradiological interventions. In neuroradiology, the mean normalized radiation exposure was 13.44 ± 1.36 µSv/10000 µGy∙m at the head protection and 22.27 ± 2.09 µSv/10 000 µGy∙m at the thyroid collar. In general radiology, the corresponding results were 29.91 ± 4.19 µSv/10 000 µGy∙m (head protection) and 68.07 ± 17.25 µSv/10 000 µGy∙m (thyroid collar). Thus, mean dose exposure was 2.5 times higher in general radiological interventions (p = 0.016). The use of the protection system resulted in a mean dose reduction of 81.2 ± 11.1 % (general radiology) and 92.1 ± 4.2 % (neuroradiology; p = 0.016).

CONCLUSION

Fluoroscopy-guided interventions lead to significant radiation exposure of the head area for the examiner. The novel protection system tested led to a significant dose reduction of 80-90%, depending on the type of intervention.

摘要

目的

由改良甲状腺领和头部保护装置组成的新型两部分保护系统旨在降低透视引导介入期间检查者头部的辐射剂量。在这项初步研究中,我们在普通放射学和神经放射学介入的实际条件下测试了该保护系统。

方法

两套保护系统(A 组和 B 组)配备了 12 个热释光探测器(TLD)。为了同时测量辐射暴露和剂量减少,将六个 TLD 分别固定在保护系统的内侧和相应的外侧。A 组仅用于普通放射学介入,B 组仅用于神经放射学介入。为了比较普通放射学和神经放射学中的工作人员暴露情况,将剂量值归一化为 10000μGy·m 的 DAP。

结果

在 20 次普通放射学介入和 32 次神经放射学介入中测试了这些设备。在神经放射学中,头部保护装置的平均归一化辐射暴露为 13.44±1.36μSv/10000μGy·m,甲状腺领的平均归一化辐射暴露为 22.27±2.09μSv/10000μGy·m。在普通放射学中,相应的结果分别为头部保护装置的 29.91±4.19μSv/10000μGy·m 和甲状腺领的 68.07±17.25μSv/10000μGy·m。因此,普通放射学介入的平均剂量暴露高 2.5 倍(p=0.016)。保护系统的使用导致平均剂量减少 81.2±11.1%(普通放射学)和 92.1±4.2%(神经放射学;p=0.016)。

结论

透视引导介入会导致检查者头部区域受到显著的辐射暴露。测试的新型保护系统导致剂量减少 80-90%,具体取决于介入类型。

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