| Bian Huahui,Liu Yulong,Wang Youyou,et al.Changes of local tissue of a case who was exposed to “5.7” 192Ir source accident in Nanjing[J].Chinese Journal of Radiological Medicine and Protection,2016,36(5):331-335 |
| Changes of local tissue of a case who was exposed to “5.7” 192Ir source accident in Nanjing |
| Received:February 05, 2016 |
| DOI：10.3760/cma.j.issn.0254-5098.2016.05.004 |
| KeyWords:192Ir Radiation injury Clinical observation Bone metabolism MRI |
| FundProject:江苏省临床医学科技专项(BL2014040);江苏省卫生计生委2014-2015年度预防医学科研项目(Y2015024) |
| Author Name | Affiliation | E-mail | | Bian Huahui | Department of Nuclear Emergency Center, Second Affiliated Hospital of Soochow University, Suzhou 215004, China | | | Liu Yulong | Department of Nuclear Emergency Center, Second Affiliated Hospital of Soochow University, Suzhou 215004, China | yulongliu2002@126.com | | Wang Youyou | Department of Nuclear Emergency Center, Second Affiliated Hospital of Soochow University, Suzhou 215004, China | | | Chen Weibo | Department of Nuclear Emergency Center, Second Affiliated Hospital of Soochow University, Suzhou 215004, China | | | Li Yuan | Department of Nuclear Emergency Center, Second Affiliated Hospital of Soochow University, Suzhou 215004, China | | | Zheng Xu | Department of Nuclear Emergency Center, Second Affiliated Hospital of Soochow University, Suzhou 215004, China | | | Bao Mingyue | Department of Nuclear Emergency Center, Second Affiliated Hospital of Soochow University, Suzhou 215004, China | | | Guo Kailin | Department of Nuclear Emergency Center, Second Affiliated Hospital of Soochow University, Suzhou 215004, China | |
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| Abstract:: |
| Objective To observe changes of local tissue injury caused by 192Ir external exposure and investigate the diagnosis and treatment of local radiation injury.Methods Observation was mainly focused on the clinical manifestations of local pathological changes, by using MRI to evaluate local tissue injury, using dual energy X-ray to detect bone mineral density(BMD) and using electrochemiluminescence (ECL) to assay bone metabolic biochemical indicators of β-CTx, PINP and serum testosterone levels. Results Exposed local skin was diagnosed as Ⅳ degree acute radiation injury to skin, showing erythema, swelling, pain, blisters, ulcers, and necrosis. The wound healed 383 days after exposure, but the right lower limb was dyskinetic. MRI eximanations showed that femoral injury on the right lower extremity involved skin, femur, multiple muscles and bone marrow tissue. BMD examination showed a reduction in bone mass(-1.5 to -1.1), transient increase in bone metabolism index β-CTx(493.50 to 1 580.00 pg/ml), and fluctuation in levels of PINP(49.30 to 291.80 ng/ml) and serum testosterone(5.41 to 608.80 ng/dl).Conclusions Acute external radiation exposure at high dose can lead to severe local tissue injury. MRI examinations are important for local damage assessment. BMD bone metabolism index and serum testosterone are useful in evaluation of bone injury. Both systemic and local therapy should be considered as equally important for local injury treatment. |
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