双平板DSA机房内剂量率分布测量  

Measurement of indoor dose rate distribution of bi-plane DSA

作　　者：张文龙 董硕[1] 花城 谢峰[1] 柳渊[1] 白玫[1] ZHANG Wen-long;DONG Shuo;HUA Cheng;XIE Feng;LIU Yuan;BAI Mei(Department of Medical Engineering,Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院医学工程处,北京100053

出　　处：《生物医学工程与临床》2023年第4期510-516,共7页Biomedical Engineering and Clinical Medicine

基　　金：北京市科学技术委员会首都临床特色应用研究课题(Z181100001718101)。

摘　　要：目的 研究双平板数字减影血管造影(DSA)机房内不同高度平面和手术者位平面辐射剂量的分布特点。方法在双平板DSA机房内,以射野中心为原点,在机房水平面的长和宽方向(X、Y方向)分别间隔50 cm设一条垂直于水平面的检测线,在每一条检测线的不同高度上(Z方向)设置检测点位。依据WS 76—2020标准指导,工作人员不易出现的区域,每条检测线距地不同高度(Z方向)设置5个检测点位;在工作人员常在位置,为了确保性腺、肠道、乳腺、胸腺、甲状腺和眼晶状体等敏感器官被准确测量,Z方向设置9个检测点位。将水模置于射野中心,在标配防护设施下,DSA双球管同时曝光,使用ATOMTEX AT1123辐射剂量监测仪检测每个点位的辐射剂量;测量值用MATLAB软件拟合不同平面辐射场。结果 手术者和麻醉师所在位置最小辐射剂量均超过了WS 76—2020标准规定的0.4 m Sv/h的限值,关注点位辐射剂量平均值差异均具有统计学意义;手术者位辐射剂量最大值均在距地105 cm左右位置,其中第一手术者位最大值超过标准限值65倍;第一、二、三手术者位所在区域辐射剂量率平均值分别为15.19 mSv/h、8.44 mSv/h、2.87 mSv/h,第一手术者位辐射剂量率与第二、三手术者位比较,差异有显著统计学意义(t=4.371,P <0.01);麻醉师常在位置辐射剂量率平均值为4.27 mSv/h,与第二、三手术者位辐射剂量率平均值差异有显著统计学意义(t=3.100,P <0.01);护士常在位置辐射剂量率平均值为0.34 mSv/h,与第三手术者位所在区域辐射剂量率差异有显著统计学意义(t=4.472,P <0.01)。双平板DSA的水平面辐射场呈现不对称的蝴蝶形分布,竖直面辐射剂量分布图大致呈现草帽状。结论 无论是水平面辐射场还是竖直面辐射场,手术者位均处于辐射场高剂量区域,必须加强辐射防护;对于麻醉师和护士位置,应设置移动铅防护区域,远离高辐射剂量区。Objective To study distribution characteristics of radiation dose at different height planes and operator plane in bi-plate digital subtractive angiography(DSA) room. Methods In bi-plane DSA room, the field center was set as the origin, a detection line perpendicular to horizontal plane was set at intervals of 50 cm in the long and wide directions(X and Y directions) of room horizontal plane, and detection positions were set at different heights(Z direction) of each detection line. According to guidance WS 76-2020 standard, five detection positions were set at Z direction of each detection line in area where the staff unusually appeared. In order to ensure that sensitive organs such as gonads, intestines, breasts, thymus, thyroid and eye lens were accurately measured, 9 detection positions were set on each line in areas where the staff usually appeared. The water model was placed in center of exposure field. Default protective facilities were used, and both tubes exposed at the same time, the ATOMTEX AT1123 radiation dose monitor was used to detect radiation dose at each detection position, and MATLAB was used to fit radiation field based on measured values. Results The minimum radiation doses at all the positions of operator and anesthesiologist exceeded the limit of 0.4 mSv/h specified in standard WS 76-2020, and the difference in mean radiation dose at concern positions were statistically significant. The maximum radiation dose of operator position was located about 105cm from the ground, and the maximum value in the first operator position exceeded the standard limit by 65 times. The mean radiation dose rates of the first, second and third operator position were 15.19 mSv/h, 8.44 mSv/h and 2.87 mSv/h, respectively. The difference between the first operator position and the second and third operator position was statistically significant(t = 4.371, P<0.01). The mean radiation dose rate of anesthesiologist was 4.27 mSv/h, which was significantly different from that of the second and third operator(t = 3.100, P<

关 键 词：神经介入 辐射场 辐射剂量 辐射防护 数字减影血管造影(DSA) 

分 类 号：R144.1[医药卫生—公共卫生与预防医学] R814.43