中华放射医学与防护杂志

康天良,冯泽臣,张宗锐,等.北京市数字X射线摄影受检者辐射剂量调查及其诊断参考水平探讨[J].中华放射医学与防护杂志,2025,45(4):346-355.Kang Tianliang,Feng Zechen,Zhang Zongrui,et al.An investigation on radiation dose and diagnostic reference level for digital radiography in Beijing[J].Chin J Radiol Med Prot,2025,45(4):346-355

北京市数字X射线摄影受检者辐射剂量调查及其诊断参考水平探讨

An investigation on radiation dose and diagnostic reference level for digital radiography in Beijing

投稿时间：2024-06-20

DOI：10.3760/cma.j.cn112271-20240620-00231

中文关键词: 辐射剂量数字化摄影平均腺体剂量诊断参考水平辐射剂量优化

英文关键词:Radiation dose Digital photography Average glandular dose Diagnostic reference level Radiation dose optimization

基金项目:

作者	单位	E-mail
康天良	首都医科大学附属北京同仁医院放射科, 北京 100730
冯泽臣	北京市疾病预防控制中心, 北京 100013
张宗锐	首都医科大学附属北京同仁医院放射科, 北京 100730
刘云福	首都医科大学附属北京同仁医院放射科, 北京 100730
张永县	首都医科大学附属北京同仁医院放射科, 北京 100730
牛延涛	首都医科大学附属北京友谊医院放射科, 北京 100050	ytniu163@163.com

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中文摘要:

目的调查北京地区成年受检者数字X射线摄影(DR)辐射剂量水平,探讨北京地区DR辐射剂量诊断参考水平(DRL)。方法选取北京市39家不同级别医疗机构,共采集18 930人次DR检查(胸部正侧位、腹部立位、腹部仰卧位、骨盆正位、颈椎正侧位、腰椎正侧位、膝关节正侧位)、5 266例乳腺DR检查头尾位(CC位)和内外斜位(MLO位)的辐射剂量数据。普通DR采用受检者入射空气比释动能(K_a,i)、入射空气比释动能面积乘积(P_KA)和有效剂量(E)作为辐射剂量的调查量和估算量,乳腺DR计算平均腺体剂量(AGD),取各医疗机构中位数的75%位数作为DRL值。结果普通DR诊断参考水平胸部正位、胸部侧位、腹部立位、腹部仰卧位、骨盆正位、颈椎正位、颈椎侧位、腰椎正位、腰椎侧位、膝关节正位、膝关节侧位的K_a,i、P_KA、E分别为0.14、0.31、1.25、2.18、1.86、0.51、0.14、2.97、8.39、0.37、0.37 mGy,159、259、1 917、2 336、2 867、312、301、3 500、3 359、269、255 mGy·cm²,0.03、0.05、0.20、0.43、0.23、0.03、0.02、0.47、0.35、<0.001、<0.001 mSv。乳腺DR诊断参考水平:CC位1.87 mGy,MLO位1.94 mGy,一次检查累积3.99 mGy。结论北京地区DR检查的辐射剂量处于较低水平,临床实践中应根据本地区诊断参考水平进一步规范成像参数的选择。

英文摘要:

Objective To investigate the radiation dose levels of digital radiography (DR) in adult patients and explore the diagnostic reference level (DRL) of radiation dose in Beijing. Methods Radiation dose data were collected from 39 medical institutions in Beijing on 18 930 DR examinations of chest anterior and lateral view, abdomen anterior and posterior view, abdomen standing view, cervical spine anterior and lateral view, lumbar spine anterior and lateral view, knee joint anterior and lateral view as well as 5 266 digital mammography (CC view and MLO view). For ordinary DR examinations, the incident air kinetic energy (K_a,i), incident air specific kinetic energy area product (P_KA) and effective dose (E) to the examined individuals were used for the investigation and estimation of radiation dose. For digital mammography, the average glandular dose (AGD) was calculated. DRLs should be set at the 75^th percentile of median values obtained in each medical institution. Results The K_a,i,P_KA and E of DRL for Chest (PA), Chest (lateral), abdominal(PA), abdominal (AP), Pelvic(AP), Cervical (AP), Cervical (lateral), Lumbar (AP), Lumbar (lateral), Knee joint (AP) and Knee joint (lateral) of conventional DR were 0.14, 0.31, 1.25, 2.18, 1.86, 0.51, 0.14, 2.97, 8.39, 0.37, 0.37 mGy, 159, 259, 1 917, 2 336, 2 867, 312, 301, 3 500, 3 359, 269, 255 mGy·cm², 0.03, 0.05, 0.20, 0.43, 0.23, 0.03, 0.02, 0.47, 0.35, <0.001, <0.001 mSv. The DRLs for digital mammography were calculated to be 1.87 mGy (CC view), 1.94 mGy (MLO view) and 3.99 mGy (accumulated for one examination). Conclusions The radiation dose from DR examinations is relatively low. In clinical practice, the selection of imaging parameters should be further standardized on the basis of the local DRL.

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