腹部介入治疗患者受照剂量调查

Radiation Dosage of Patients Treated by Abdomen Intervention Therapy

目的通过采用DSA机自带的Area Exposure Product Meter穿透电离室型剂量监测系统测量剂量面积乘积值(DAP)以及参考点的累积剂量(CD)值,用Monte Carlo转换系数分别估算出患者的有效剂量(ED)及入射体表剂量率(ESDR),测量腹部放射介入诊疗中患者的基本剂量学参数,开展放射介入诊断参考水平调查。方法数据处理采用SPSS v13.0版本,参照ICRP第103号出版物和WS/T189-1999《医用X射线诊断设备影像质量控制检验规范》及附录中提供的方法进行。结果肝动脉化疗栓塞组、肝部血管治疗和宫颈癌治疗组DAP的75%分位数分别为76.9、75.3、51.9 Gy/cm2;其中单次操作ED>10 mSv在各组中所占比例分别为29.4%、29.2%和13.2%;仅有2例ESDR值超过100 mGy/min。结论 DAP的75%分位数可作为医疗照射相应放射介入操作的诊断参考水平(diagnostic reference lev-el,DRL),为了确定某一地区某一特定操作类型的DRL值还需要收集大量的调查数据和开展剂量学模型的验证工作。

Objective The values of dose area product（DAP） and cumulative dose（CD） of reference point mensured by Area Exposure Product Meter dosimeter system equipped with DSA,the effective dose（ED） and entrance surface dose（ESD） of patients were estimated with Monte Carlo Conversion coefficient,the common dosimetric parameters of patients treated with abdomen intervention therapy were meatured,and the reference level of interventional diagnosis was investigated.Methods The data processing was conducted with SPSS v13.0,and the method was performed according to the ICRP Publication 103 and WS/T189-1999.Results The 75th percentile of DAP on transcatheter arterial chemoembolization（TACE）,therapy for livervascular diseases,therapy for cervical carcinoma was 76.9 Gy/cm2,75.3 Gy/cm2 and 51.9 Gy/cm2;respectively.One single operation ED10mSv proportion in each group were 29.4%,29.2% and 13.2% respectively;only 2 value of ESDR were above 100 mGy/min.Conclusion 75th percentile of DAP could be regaeded as the diagnostic reference level（DRL） in medical radioactive intervention.In order to define the DRL in some specific operations,it is necessary to collect mass data of investigation and carry out the verification of dosimetric model.