Taylor K W, Patt N L, Johns H E
J Can Assoc Radiol. 1979 Mar;30(1):6-11.
X-ray exposures to patients were measured in 30 rooms in Toronto hospitals. For a given procedure, the total exposure for a satisfactory examination differed from one room to another by as much as a factor of 30, skin exposures reaching 90 R and more for barium enemas and barium meals. The factors primarily responsible for these large differences in exposure were fluoroscopic exposure rate (0.65-12 R/min) and time 1.5-12 min), kVp and filtration (8:1), choice of screen-film combination (6:1) and attenuation of table tops and phototimers (4:1). The increase by a factor of 5 in exposure of pelvic organs, when using beams directed AP instead of PA, requires that remote-controlled GI machines be used cautiously, particularly on women of childbearing age. It is also important that these machines have tables with low attenuation. The use in some rooms of minimal fluoroscopic exposure rates and 70 mm fluorography at total exposures of less than 5 R shows that radiographic examinations can be made virtually "safe" with modern, properly adjusted equipment.
在多伦多各医院的30间诊室测量了患者接受的X射线照射量。对于某一特定检查程序,一次满意检查的总照射量在不同诊室之间相差多达30倍,钡灌肠和钡餐检查时皮肤照射量可达90伦琴甚至更高。造成这些照射量巨大差异的主要因素有:荧光透视照射率(0.65 - 12伦琴/分钟)和时间(1.5 - 12分钟)、千伏峰值和滤过(8:1)、增感屏 - 胶片组合的选择(6:1)以及检查台台面和自动曝光控时器的衰减(4:1)。使用前后位投照而非后前位投照时,盆腔器官的照射量会增加5倍,这就要求谨慎使用遥控胃肠造影机,尤其是对育龄女性。同样重要的是,这些机器的检查台要有低衰减特性。在一些诊室,采用最低荧光透视照射率以及总照射量低于5伦琴时进行70毫米的X线摄影,这表明使用现代的、经过适当调整的设备,X线检查实际上可以做到“安全”。