通过剂量面积乘积估算内镜逆行胰胆管造影患者的有效剂量

Estimation of effective dose to patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) from DAP measuring

目的估算内镜逆行胰胆管造影(ERCP)操作中患者的辐射剂量水平,为制定介入放射学中患者的防护标准提供科学依据。方法以ERCP手术调查的相关参数(透视时间、点片张数及设备相关参数)为条件,测量剂量面积乘积(DAP),并利用测量的DAP值,通过基于蒙特卡罗(Monte Carlo)计算方法剂量估算软件(Ref Dose),估算出患者的有效剂量(Effective Dose,E)。结果按照操作难易程度分组,患者有效剂量分别为:ERCP操作复杂组4.448 mSv、ERCP操作中等组0.715 mSv、ERCP操作简单组0.247 mSv。结论患者有效剂量的大小与3个剂量组中透视时间及DAP值呈正相关关系。ERCP手术中,在不影响临床效果的情况下,应尽可能缩短透视时间、减少摄片帧数、缩小照射野,从而尽可能降低患者的有效剂量。

Objective To investigate the radiation dose level of patients in ERCP operation,and to provide scientific basis for formulating the protection standard of patients in interventional radiology.Methods The dose-area product(DAP)was measured with water model under the condition of the parameters of ERCP operation investigation(fluoroscopy time,number of photographs and equipment parameters),and the effective dose(E)was estimated by using the measured DAP value.Results The effective doses of the complex ERCP group,the middle ERCP group and the simple ERPC group are 4.448 mSv,0.715 mSv,0.247 mSv,respectively.Conclusion The effective dose of the patient was positively correlated with the fluoroscopy time and DAP value in the three dose groups.In ERCP operation,the fluoroscopy time should be shortened,the number of photographic frames should be reduced,and the radiation field should be reduced as much as possible so as to reduce the radiation dose of patients.