患者双下肢X射线一次性曝光中性腺受照剂量测量与分析  

Measurement and Analysis of Gonadal Irradiation Dose During Singe-shot X-ray Exposure of Both Lower Limbs

作　　者：王策 周凤云 轩艳姣 王文海 姚麟 施政 马永忠[2] 程晓光 WANG Ce;ZHOU Fengyun;XUAN Yanjiao;WANG Wenhai;YAO Lin;SHI Zheng;MA Yongzhong;CHENG Xiaoguang(Epartment of Radiology,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Beijing Center for Disease Control and Prevention Radiation Health Protection Institute,Beijing 100013,China)

机构地区：[1]首都医科大学附属北京积水潭医院放射科,北京100035 [2]北京市疾病预防控制中心放射卫生防护所,北京100013

出　　处：《CT理论与应用研究（中英文）》2024年第5期627-632,共6页Computerized Tomography Theory and Applications

基　　金：北京市医院管理中心临床医学发展专项(肌骨影像学(ZYLX202107));北京市属医学科研院所公益发展改革试点项目(京医研2023-8);北京市高层次公共卫生技术人才建设项目(学科带头人-01-02)。

摘　　要：目的:探讨双下肢数字化X射线摄影中患者性腺的体表摄入剂量(ESD)与性别、年龄、身高和体重等生理参数之间的关系,探讨一次性曝光全幅长板成像的辐射剂量在临床的可行性。方法:前瞻性收集双下肢负重位患者300例,其中男性129例,女性171例。收集双下肢正位和正侧位扫描的患者,摄片时分别在患者的两侧性腺部位设置(TLD)探测器,曝光后使用RGD-3B型热释光剂量仪对其测读,得出相应的剂量值并分析。结果:全副长板成人模式的3次曝光剂量(正位+双侧位)为(1281±202)μGy,是单次曝光剂量(429±99)μGy的3倍左右,3次曝光的剂量(正位+双侧位)显著低于国际规定的辐射剂量;使用多元线性回归分析表明只有身高和体重是性腺辐射剂量的影响因素,而与性别和年龄无关。在儿童扫描参数下,身高<160 cm的ESD剂量为(359±27)μGy,身高>160 cm的ESD剂量为(627±155)μGy,有显著的统计学差异;在成人模式下,身高和体重并不影响ESD剂量。结论:本研究表明单次曝光技术行负重位双下肢全长扫描时性腺的受照剂量与身高和体重有关。性腺所受剂量在安全范围内,一次曝光全副长板的辐射剂量在临床实践中可行。Objective:To investigate the relationship between entrance surface dose(ESD)of gonads and physiological parameters such as sex,age,height,and weight in digital X-ray exposure of both lower limbs and to explore the feasibility of full-width long-plate imaging with single-dose radiation exposure.Methods:A total of 300 patients at a weight-bearing position of both lower limbs were prospectively enrolled in a hospital in Beijing,including 129 males and 171 females.The TLD detectors were set at the gonads on both sides of the patient during scanning.After exposure,the TLD detectors were measured with an RGD-3B thermoluminescence dosimeter,and the corresponding dose values were obtained and analyzed.Results:The average triple exposure dose(AP+bilateral view)in the full-length plate adult mode was(1281±202)μGy,which was approximately three times the single exposure dose(429±99)μGy.The triple exposure dose(AP+bilateral view)was significantly lower than the radiation dose recommended by international standards.Multiple linear regression analysis showed that only height and weight affected gonadal radiation dose.Under the scanning parameters of children,the ESD dose was(359±27)μGy and(627±155)μGy when the height was less or more than 160 cm,respectively,with a significant statistical difference.In adult mode,height and weight did not affect the ESD dose.Conclusions:This study showed that the exposure dose of gonads during full-length scanning of both lower limbs in a weight-bearing position with a single exposure was affected by height and weight.The dose received by the gonads was within the safe range,and a single exposure of the fulllength plate radiation dose is feasible in clinical practice.

关 键 词：X射线 双下肢摄影 性腺 受照剂量 

分 类 号：R814[医药卫生—影像医学与核医学] R144[医药卫生—放射医学]