CT引导介入操作中患者有效辐射剂量的研究

Radiation dose received by the patients in performing CT-guided interventional procedures

目的探讨CT引导下各类介入操作中患者接受的有效辐射剂量。方法回顾性分析近2年来我科CT引导下介入诊断和治疗259例次患者的检查资料。介入操作包括穿刺活检、引流、射频消融、经皮瘤内无水乙醇注射术、放射性^(125)Ⅰ粒子植入术、腹腔神经丛阻滞术等6种方法。浏览PCAS系统上的医学信息和图像,并记录患者所接受的介入诊疗方式、扫描时间、扫描次数、总毫安秒、CT剂量指数、剂量长度乘积。有效辐射剂量根据国际放射防护委员会(ICRP)制定的蒙特卡罗有效剂量转换公式进行计算。结果放射性^(125)Ⅰ粒子植入术、经皮瘤内无水乙醇注射术、射频消融术、腹腔神经丛阻滞术、引流、活检平均有效辐射剂量分别是(25.62±10.43)mSv、(19.02±7.35)mSv、(18.69±6.39)mSv、(16.22±5.60)mSv、(10.66±4.51)mSv和(9.67±3.81)mSv,粒子植入术的有效辐射量明显高于其他介入操作,差异有统计学意义。结论 CT引导下单次介入操作有效辐射剂量相对较小,引起辐射损伤及后续并发症的危险小,但多次介入治疗累积的有效辐射剂量可能会较大,需要引起一定的重视。

Objective To determine the effective radiation dose to patients undergoing CT-gnided interventional procedures. Methods A total of 259 patients undergoing CT-gnided interventional procedures in resent 2 years were included in this retrospective data analysis study. All patients underwent one of the following six procedures： biopsy, drain, radiofrequency ablation, percutaneous ethanol injection to tumor, 125I seed implantation, percutaneous neurolytic block of celiac plexus. Medical records and images stored in PACS were retrospectively reviewed in order to obtain the following data： the type of CT-guided interventional procedure, the scanning time, the scanning numbers, the totsl dose of mAs and the total does-length product. Effective dose was calculated by multiplying does-length product （DLP） by conversion factor （K factor） using Monte Carlo organ dose coefficients for intermittent mode. Results The mean plus SD effective doses for 125I seed implantation, pereutaneous ethanol injection to tumor, radiofrequency ablation, percutaneous neurolytic block of celiac plexus, drain and biopsy procedures were （25.62 ± 10.43） mSv, （19.02 ± 7.35） roSy, （18.69 ±6.39） mSv, （16.22 ± 5.60） mSv, （10.66 ± 4.51） mSv, （9.67 ± 3.81） mSv, respectively. The radiation dose received by the patient in 125I seed implantation procedure was significantly higher than those in any other interventional procedures. Conclusion Single CT-guided interventional procedure may not produce too much radiation to patient, but the cumulated effective radiation dose produced by many times of CT-guided interventional treatments might be considerably higher to patients.