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多学科工作人员在复杂介入手术过程中的辐射剂量。

Radiation dose to multidisciplinary staff members during complex interventional procedures.

机构信息

Research and Innovation Unit of Radiology, University of Southern Denmark, Kloevervaenget 10, 2nd. Floor. 5000 Odense C, Denmark; Department of Radiology, Odense University Hospital, JB Winslows Vej 4, 5000 Odense C, Denmark; Faculty of Health Sciences, Oslo Metropolitan University, Pilestedet 48, Oslo, Norway.

Department of Radiology, Odense University Hospital, JB Winslows Vej 4, 5000 Odense C, Denmark.

出版信息

Radiography (Lond). 2024 Mar;30(2):512-516. doi: 10.1016/j.radi.2024.01.010. Epub 2024 Jan 19.

Abstract

INTRODUCTION

Complex interventional radiology procedures involve extensive fluoroscopy and image acquisition while staff are in-room. Monitoring occupational radiation dose is crucial in optimization. The purpose was to determine radiation doses received by staff involved in complex interventional procedures performed in a dedicated vascular or neuro intervention room.

METHODS

Individual real-time radiation dose for all staff involved in vascular and neuro-interventional procedures in adult patients was recorded over a one-year period using wireless electronic dosimeters attached to the apron thyroid shield. A reference dosimeter was attached to the C-arm near the tube housing to measure scattered, unshielded radiation. Radiology staff carried shoulder thermo-luminescent dosimeters with monthly read-out to monitor dose over time.

RESULTS

Occupational radiation dose was measured in 99 interventional procedures. In many cases prostate artery embolization procedures exposed radiologists to high radiation doses with a median of 15.0 μSv and a very large spread, i.e. 0.2-152.5 μSv. In all procedures except uterine fibroid embolization radiographers were exposed to lower doses than those of radiologists, with endovascular aortic repair being the procedure with highest median exposure to assisting radiographers, i.e. 2.2 μSv ranging from 0.1 to 36.1 μSv. Median radiation dose for the reference dosimeter was 670 μGy while median staff dose for all procedures combined was 3.2 μGy.

CONCLUSION

Radiation doses for multiple staff were determined and the ratio between staff dose and reference dosimeter indicated proper use of shielding in general. Some high-dose procedures may need further optimization for certain staff members, especially those not primarily employed in radiology.

IMPLICATIONS FOR PRACTICE

The study provides benchmark doses that may be used widely in audits and in the ongoing effort to optimize radiation protection for staff in interventional radiology.

摘要

简介

复杂的介入放射学程序涉及广泛的透视和图像采集,而工作人员在房间内。监测职业辐射剂量对于优化至关重要。目的是确定在专门的血管或神经介入室进行的复杂介入程序中涉及的工作人员所接受的辐射剂量。

方法

在一年的时间里,使用附着在围裙甲状腺屏蔽上的无线电子剂量计,记录所有参与成人患者血管和神经介入程序的工作人员的实时个体辐射剂量。将一个参考剂量计附着在靠近管壳的 C 臂上,以测量散射的、未屏蔽的辐射。放射科工作人员携带肩部热释光剂量计,每月读取一次,以监测随时间推移的剂量。

结果

在 99 项介入程序中测量了职业辐射剂量。在许多情况下,前列腺动脉栓塞程序使放射科医生暴露在高辐射剂量下,中位数为 15.0 μSv,分布范围很大,即 0.2-152.5 μSv。除了子宫纤维瘤栓塞程序外,在所有程序中,放射技师所受的辐射剂量都低于放射科医生,而血管内主动脉修复程序是对辅助放射技师辐射暴露最高的程序,中位数为 2.2 μSv,范围为 0.1 至 36.1 μSv。参考剂量计的辐射剂量中位数为 670 μGy,而所有程序综合的工作人员剂量中位数为 3.2 μGy。

结论

确定了多名工作人员的辐射剂量,工作人员剂量与参考剂量计的比值表明一般屏蔽的正确使用。一些高剂量程序可能需要进一步优化,特别是对于那些非主要从事放射科工作的人员。

意义

该研究提供了基准剂量,可以在审计和持续努力优化介入放射科工作人员的辐射防护中广泛使用。

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