介入诊疗程序中患者皮肤最大受照剂量的检测与评价  

Measurement and estimation of maximum skin dose to the patient for different interventional procedures

作　　者：程玉玺[1] 郁鹏[2] 尉可道[1] 刘澜涛[1] 燕树林[2] 李田昌[2] 

机构地区：[1]中国疾病预防控制中心辐射防护与核安全医学所,北京100088 [2]首都医科大学附属北京同仁医院

出　　处：《中华放射医学与防护杂志》2005年第6期543-545,共3页Chinese Journal of Radiological Medicine and Protection

基　　金：首都医学发展科研基金资助项目(20023026)

摘　　要：目的测定冠脉造影、肝动脉造影、射频消融、脑动脉造影等介入程序中对患者主射束皮肤剂量分布和最大皮肤受照剂量,了解患者皮肤能否发生确定性效应。方法在冠脉造影、肝动脉造影和射频消融3种手术曝光前每个患者背部放9个测量点,每个点2片LiF(Mg,Cu,P)剂量片;脑动脉造影曝光前患者正、侧位各放1个测量点。手术后进行TLD测量。结果肝动脉造影手术时,患者皮肤最大吸收剂量为1683.9mGy,平均吸收剂量607.3mGy;脑动脉造影正位时最大值可达959.3mGy,平均值418.8mGy;侧位最高达704mGy,平均191.52mGy;射频消融最高值为853.8mGy,平均219.7mGy;冠脉造影最大值为456.1mGy,平均227.6mGy。结论本实验结果是对皮肤最大剂量的一种估计值,尚不能精确提供患者皮肤受照的最大值,因为剂量片布放不够密集,可能没有包括很小的高剂量部位。Objective To determine the dose distribution and maximum skin dose to the patient for four interventional procedures ： coronary angiography （CA）, hepatic angiography（HA）, radiofrequency ablation （RF） and cerebral angiography（CAG） , and to estimate the definitive effect of radiation on skin. Methods Skin dose was measured using LiF： Mg, Cu, P TLD chips. A total of 9 measuring points were chosen on the back of the patient with two TLDs placed at each point, for CA, HA and RF interventional procedures , whereas two TLDs were placed on one point each at the postero-anterior（PA） and lateral side （LAT） respectively, during the CAG procedure. Results The results revealed that the maximum skin dose to the patient was 1683.91 mGy for the HA procedure with a mean value of 607.29 mGy. The maximum skin dose at the PA point was 959.3 mGy for the CAG with a mean value of 418.79 mGy; While the maximum and the mean crises at the LAT point were 704 mGy and 191.52 mGy, respectively. For the RF procedure the maximum dose was 853.82 mGy and the mean was 219.67 mGy. For the CA procedure the maximum dose was 456.1 mGy and the mean was 227.63 mGy. Conclusion All the measured dose values in this study are estimated ones which could not provide the accurate maximum value because it is difficult to measure using a great deal of TLDs. On the other hand , the small area of skin exposed to high dose could be missed as the distribution of the dose is successive.

关 键 词：介入放射学 血管造影 医疗照射 最大皮肤受照剂量 

分 类 号：R144[医药卫生—公共卫生与预防医学]