| 徐辉,岳保荣,尉可道,王建超,范瑶华.我国X射线摄影程序受检者入射体表剂量调查结果与分析[J].中华放射医学与防护杂志,2019,39(1):68-72 |
| 我国X射线摄影程序受检者入射体表剂量调查结果与分析 |
| Investigation and analysis on entrance surface dose of patients in radiography procedures in China |
| 投稿时间：2018-04-09 |
| DOI：10.3760/cma.j.issn.0254-5098.2019.01.013 |
| 中文关键词: 屏片X射线摄影 计算机X射线摄影(CR) 直接数字化X射线摄影(DR) 入射体表剂量(ESD) 诊断参考水平 |
| 英文关键词:Screen-film radiography Computed radiography (CR) Digital radiography (DR) Entrance surface dose (ESD) Diagnostic reference level |
| 基金项目:卫生行业科研专项（201002009） |
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| 中文摘要: |
| 目的 通过调查全国15个省市不同级别医疗机构使用数字和屏片设备开展X射线摄影时受检者的入射体表剂量（ESD），为制定适合我国国民体质特征的X射线摄影诊断参考水平提供数据。方法 按照《医用辐射危害评价与控制技术研究》实施方案的要求，选择年龄在20~70岁的受检者，男性体重在55~80 kg，女性体重在50~70 kg；采用热释光探测器（TLD）测量不同X射线摄影程序中成人受检者ESD，每台设备同一体位患者应不少于10名受检者；测量部位包含头颅、胸部的后前位（PA）和侧位（LAT），腹部、骨盆、腰椎、胸椎的前后位（AP）和腰椎、胸椎的LAT等。结果 共在全国15个省的342家医院调查了19 975例X射线摄影受检者，1 813台不同类型X射线摄影设备，包括屏片X射线摄影、计算机X射线摄影（CR）和直接数字化X射线摄影（DR）设备，对于这3种类型的设备，不同摄影体位时受检者ESD的平均值分别为头颅PA：1.75、1.90、1.15 mGy；头颅LAT：1.69、1.46、1.03 mGy；胸部PA：0.75、0.65、0.36 mGy；胸部LAT：1.81、1.26、0.88 mGy；腹部AP：4.37、3.77、2.15 mGy；骨盆AP：3.73、3.56、2.75 mGy；腰椎AP：5.49、5.84、4.17 mGy；腰椎LAT：12.01、9.37、6.82 mGy；胸椎AP：4.53、3.65、2.49 mGy；胸椎LAT：6.91、6.43、4.15 mGy。结论 不同照射部位X射线摄影致受检者ESD有较大的差异。DR设备致受检者的ESD均低于屏片设备；除胸椎AP外，DR设备致受检者ESD均低于CR设备。在所有检查部位中，CR和屏片设备所致受检者ESD的差异均无统计学意义。 |
| 英文摘要: |
| Objective To investigate the entrance surface dose to the examined patients in radiography using digital and screen-film system in hospitals at different levels in 15 provinces and municipalities in China, in order to provide data for developing diagnostic reference level of radiography suitable for our national physical characteristics.Methods According to the requirements of the Technical Study on Medical Radiation Hazard Assessment and Control, the examined patients aged 20-70 years were selected, with body weight ranging from 55 to 80 kg for male and 50 to 70 kg for female. TLDs were used to measure the entrance surface dose to adult patients in radiography. No less than 10 examined patients were required at each body position, with examined locations including head (PA, LAT), chest (PA, LAT), abdomen (AP), pelvis (AP), lumbar (AP, LAT), and thoracic vertebra (AP, LAT).Results A total of 19 975 individuals undergoing radiography and 1 813 radiographic equipment of different types including screen-film radiography, computed radiography (CR) and digital radiography (DR), were investigated in 342 hospitals in 15 provinces and municipalities throughout the country. For these three types of equipment, the average entrance surface dose to the examined were 1.75, 1.9, and 1.15 mGy in head (PA), 1.69, 1.46 and 1.03 mGy in head (LAT), 0.75, 0.65 and 0.36 mGy in chest (PA), 1.81, 1.26 and 0.88 mGy in chest (LAT), 4.37, 3.77 and 2.15 mGy in abdomen (AP), 3.73, 3.56 and 2.75 mGy in pelvis (AP), 5.49, 5.84 and 4.17 mGy in lumbar (AP), 12.01, 9.37 and 6.82 mGy in lumbar (LAT), 4.53, 3.65 and 2.49 mGy in thoracic vertebra (AP), and 6.91, 6.43 and 4.15 Gy in thoracic vertebra (LAT).Conclusions Entrance surface dose caused by radiography examination varies dependent on different exposure locations. Entrance surface doses caused by digital radiography are all lower than by screen-film radiography; those caused by digital radiography are lower than by computed radiography, except for thoracic vertebra (AP). In all examinations, no difference of statistical significance is found between CR and screen-film radiography in entrance surface dose. |
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