Palmer S H, Starritt H C, Paterson M
Department of Orthopaedics, Royal United Hospital, Bath, UK.
Eur Spine J. 1998;7(4):278-81. doi: 10.1007/s005860050075.
Concerns in clinical practice arose over the amount of ovarian irradiation received from X-ray examinations in females with scoliosis. This study was instigated to assess the adequacy of ovarian protection in this young and genetically vulnerable group of patients. A total of 283 plain films in 20 patients with scoliosis were reviewed. If the area immediately adjacent to the medial wall of the acetabulum was clearly seen, then this was taken as indicative of ovarian irradiation. In a separate study, the radiation dose in the centre of the X-ray field on the surface of a tissue-equivalent anthropomorphic phantom was measured using thermoluminescent dosimeters. Standard conditions for scoliosis X-ray examination were used. The average age of patients was 21.5 years. The mean number of single X-ray exposures per patient was 14.1 over a mean of 44 months. The mean measured entrance dose to the skin in the 20 patients was 0.08 mGy (equivalent dose = 0.08 mSv). The mean percentage of examinations without lead protection was 18% per patient (range 0-40%). This would have resulted in a mean equivalent dose to the surface of the abdomen of 0.1 mSv per year per patient from the unprotected examinations. The maximum dose received in 1 year was 0.6 mSv. The maximum dose to the unprotected ovary was estimated to be 0.05 mSv from a single examination. The mean total cumulative ovarian dose was calculated as 180 microSv per patient (range 45-355 microSv) over the time period studied. The findings of this study indicate that ovarian protection should be improved. Reasons for this and suggestions for improvement are discussed.
临床实践中出现了对脊柱侧凸女性患者因X线检查而接受的卵巢辐射量的担忧。开展这项研究是为了评估对这群年轻且基因易损患者的卵巢保护是否充分。对20例脊柱侧凸患者的283张平片进行了回顾。如果紧邻髋臼内壁的区域清晰可见，则将其视为卵巢受到辐射的指征。在另一项研究中，使用热释光剂量计测量了组织等效人体模型表面X线射野中心的辐射剂量。采用了脊柱侧凸X线检查的标准条件。患者的平均年龄为21.5岁。每位患者在平均44个月内的单次X线曝光平均次数为14.1次。20例患者皮肤的平均测量入射剂量为0.08毫戈瑞（当量剂量 = 0.08毫希沃特）。每位患者无铅防护检查的平均百分比为18%（范围0 - 40%）。这将导致每位患者每年因未防护检查而腹部表面的平均当量剂量为0.1毫希沃特。1年内接受的最大剂量为0.6毫希沃特。单次检查中未防护卵巢的最大剂量估计为0.05毫希沃特。在所研究的时间段内，每位患者卵巢的平均总累积剂量计算为180微希沃特（范围45 - 355微希沃特）。本研究结果表明应改进卵巢保护。讨论了其原因及改进建议。
