Occupational exposure from common fluoroscopic projections used in orthopaedic surgery
Occupational exposure from common fluoroscopic projections used in orthopaedic surgery
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DOI：
10.2106/00004623-200309000-00007
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发表时间：
2003-09-01
影响因子：
5.3
通讯作者：
Gourtsoyiannis, N
中科院分区：
文献类型：
--
作者：
Theocharopoulos, N;Perisinakis, K;Gourtsoyiannis, N
背景：协助或执行透视引导手术的人员可能暴露于高剂量辐射。orthopaeclic剧院的工作人员准确的职业剂量测定数据是最重要的实践radiation safety.Methods：透视筛选上进行了拟人模型与使用常见的四个预测在图像引导下的骨科手术。根据成像的解剖区域和射束方向，将模拟投影分类为（1）髋关节后-前，（2）髋关节外侧十字台450，（3）腰椎前-后，和（4）腰椎外侧90度。在手术台周围的网格上测量散射空气比释动能率。对于每个网格点，推导出有效剂量、眼透镜剂量和面部皮肤剂量值，并在管剂量面积乘积上进行归一化。在计算有效剂量时，考虑了三种辐射防护条件：（1）受照人员未采取防护措施;（2）受照人员穿戴0.5 mm铅当量防护围裙;（3）受照人员穿戴围裙和甲状腺项圈。典型髋关节、脊柱和椎体后凸成形术的最大允许工作量是根据有效剂量、眼透镜剂量和皮肤剂量限值的符合性得出的。结果：我们发现，如果透视引导手术的剂量面积乘积为
Background: Personnel assisting in or performing fluoroscopically guided procedures may be exposed to high doses of radiation. Accurate occupational dosimetric data for the orthopaeclic theater staff are of paramount importance for practicing radiation safety.Methods: Fluoroscopic screening was performed on an anthropomorphic phantom with use of four projections common in image-guided orthopaedic surgery. The simulated projections were categorized, according to the imaged anatomic area and the beam orientation, as (1) hip joint posterior-anterior, (2) hip joint lateral cross-table 450, (3) lumbar spine anterior-posterior, and (4) lumbar spine lateral 90degrees. The scattered air kerma rate was measured on a grid surrounding the operating table. For each grid point, the effective dose, eye lens dose, and face skin dose values, normalized over the tube dose area product, were derived. For the effective dose calculations, three radiation protection conditions were considered: (1) with the exposed personnel using no protection measures, (2) with the exposed personnel wearing a 0.5-mm lead-equivalent protective apron, and (3) with the exposed personnel wearing both an apron and a thyroid collar. Maximum permissible workloads for typical hip, spine, and kyphoplasty procedures were derived on the basis of compliance with effective dose, eye lens dose, and skin dose limits.Results: We found that the effective dose, eye lens dose, and face skin dose to an orthopaeclic surgeon wearing a 0.5mm lead-equivalent apron will not exceed the corresponding limits if the dose area product of the fluoroscopically guided procedure is