Hayashi N, Sakai T, Kitagawa M, Inagaki R, Yamamoto T, Fukushima T, Ishii Y
Department of Radiology, Fukui Medical University School of Medicine, Japan.
Cardiovasc Intervent Radiol. 1998 May-Jun;21(3):240-3. doi: 10.1007/s002709900252.
We investigated the relationship between the amount of radiation exposure to the operator during table-side manual-injection angiographic procedures including digital subtraction angiography (DSA) and the operator's position, as well as a simple means to decrease radiation exposure.
Measurement of radiation exposure was carried out with thermoluminescent dosimeters (TLDs) in nine abdominal angiographies. In the first study, radiation exposure during DSA or during fluoroscopy was measured using TLDs placed near the angiographic table. In the second study, radiation exposure to the interventional radiologist was measured during manual-injection DSA at a near and a far operator position.
Radiation exposure to the operator received during manual-injection DSA accounted for more than 90% of the total procedural exposure. The exposure to the operator markedly decreased at the far position compared with that at the near position when performing DSA.
Manual-injection DSA is the largest contributor to radiation exposure received by the interventional radiologist, therefore, the use of a power injector is always recommended when performing DSA. When manual-injection DSA is necessary, radiologists should position themselves as far away from the patient as possible.
我们研究了包括数字减影血管造影（DSA）在内的床边手动注射血管造影术过程中操作者所受辐射量与操作者位置之间的关系，以及一种减少辐射暴露的简单方法。
在9例腹部血管造影术中使用热释光剂量计（TLD）测量辐射暴露。在第一项研究中，使用放置在血管造影台附近的TLD测量DSA或透视期间的辐射暴露。在第二项研究中，在手动注射DSA期间，在操作者近位和远位测量介入放射科医生所受的辐射暴露。
手动注射DSA期间操作者所受的辐射暴露占整个操作过程总暴露的90%以上。与近位相比，在远位进行DSA时操作者所受的暴露明显减少。
手动注射DSA是介入放射科医生所受辐射暴露的最大来源，因此，进行DSA时始终建议使用动力注射器。当必须进行手动注射DSA时，放射科医生应尽可能远离患者定位。
