广州市X射线诊断致受检者体表剂量水平

目的 掌握广州市常用X射线诊断检查致受检者入射体表剂量(ESD),为广州市医疗照射防护最优化提供依据。方法 选择广州市较常用的X射线诊断机及其常用条件,按照全国统一调查方案,对13种检查类型致受检者的ESD进行了检测。结果 腰椎侧位摄影检查致受检者的ESD最高,胸片正位摄影检查致受检者的ESD最低。广州市受检者胸部正位摄影的ESD与广东省测值、全国测值,以及GB18871-2002标准中"放射诊断的医疗照射指导水平"接近;广州市受检者胸部侧位和腰部侧位摄影的ESD都低于广东省、全国测值和GB18871-2002标准中"放射诊断的医疗照射指导水平";广州市受检者腰部正位摄影的ESD高于广东省和全国测值,但低于GB18871-2002标准中"放射诊断的医疗照射指导水平"。结论 控制受检者ESD是医疗照射防护最优化的重要内容,应根据具体情况建立适合广州市X射线诊断的指导水平。     

X射线诊断所致受检者剂量的表征与监测方法

目的 探讨X射线诊断中受检者剂量的表征与监测方法,为建立既与国际接轨,又适合我国实际的医疗照射指导水平提供科学依据。方法 根据本课题组的实验结果和有关国际组织的建议进行综合分析评价。结果 讨论了常规X射线检查、CT检查、乳腺和牙科检查的剂量当量和测量方法。结论 建立X射线诊断医疗照射的指导水平,必将有力推进辐射防护最优化的进展。     

某部队医疗放射工作人员个人剂量水平评价

目的 了解二炮医疗放射工作人员外照射个人剂量水平。方法 采用热释光剂量方法监测。结果 二炮医疗放射工作人员个人剂量在0.93~1.76 mSv之间,年个人剂量超过职业照射剂量限值20 mSv的人员为1.8%。结论 二炮医疗放射工作人员的个人剂量有下降趋势,不同职业外照射人均年剂量以医用Φ射线诊断为最高。     

现行放射诊疗卫生防护相关法规标准对医疗照射的控制

目的 分析现行法规标准对医疗照射的控制,探讨降低医疗照射的途径。方法 综合现行法规标准有关规定,对影响医疗照射的各种因素进行讨论。结果 现行法规标准在人员、设备和质控以及正当性判断与最优化、剂量指导水平等方面都提出了明确的要求。结论 通过提高准入条件,加强正当性判断、最优化和质量保证工作,推行医疗照射指导水平,合理降低医疗照射剂量,是目前放射诊疗卫生防护工作的重点。     

河南省X射线诊断医疗照射频率及剂量调查

目的 了解河南省X射线诊断医疗照射的频率及剂量水平。方法 采取普查、分层抽样与重点调查相结合。结果 1996、1998年X射线诊断医疗照射的年频率水平分别为每千人134.59人次和139.27人次。结论 胸透检查剂量有明显降低。     

医疗照射防护中有关放射诊断的放射卫生标准现状分析

目的 为我国医疗照射防护中放射诊断相关的标准及标准化工作提供有益的意见和建议。方法 根据医疗照射防护的原则,分析我国放射诊断相关的放射卫生标准现状,提出合理的建议。结果 至2018年12月,医疗照射防护中有关放射诊断的现行有效放射卫生标准共21项,标准内容较为全面,基本覆盖了在放射诊断过程中实践医疗照射防护原则所需要的各个方面,但诊断参考水平等标准需要加强。结论 我国医疗照射防护中有关放射诊断的放射卫生标准较为完备,标准内容涵盖全面。在诊断参考水平、设备质量控制检测等方面需进一步完善。     

周口市X射线诊断医疗照射频率水平调查

目的 了解周口市X射线诊断及其各种类型医疗照射频率,为X射线防护工作提供科学依据。方法 采取普查与分层抽样调查相结合。结果 1996年、1998年X射线诊断医疗照射年频率分别为93.10人次/千人、102.05人次/千人,两年透视检查分别占所有检查的41.46%、40.02%。结论 X射线诊断医疗照射频率水平较低,但结构趋于合理,X-CT检查所占比例较小,但发展快。放射诊断人员素质有待提高。     

阳泉市X射线诊断医疗照射频率水平调查

目的 掌握阳泉市X射线诊断医疗照射的应用频率,进一步提高阳泉市放射卫生监督管理水平。方法 按照"九五"期间全国医疗照射调查方案的要求和山西省卫生厅的统一安排和要求进行,对阳泉市X射线诊断应用基本状况及1996年、1998年X射线诊断检查人次数进行了调查。结果 阳泉市1996年和1998年X射线诊断的总应用频率分别为304.86/千人和295,96/千人。结论 阳泉市X射线诊断的总应用频率较高,高于全国平均水平和山西省平均水平。在X射线诊断应用频率增高的情况下,应加强医疗照射的防护,采取各种有效措施,合理降低平均每次检查所致受检者剂量。     

宜昌市X射线诊断医疗照射调查

目的 掌握宜昌市医疗照射情况。方法 根据全国"九五期间医疗照射调查方案",结合宜昌市推广放射卫生综合管理示范市工作特点,以医疗单位的X射线诊断医疗照射量为依据分层进行X射线诊断医疗照射频率抽样调查。结果 人口集中、经济条件好、医疗设备和技术条件高的城区医疗照射频率明显高于乡村;医疗照射中X射线摄影已替代透视成为主要检查项目。结论 放射介入诊疗技术发展较快,有关部门应尽快出台相应管理措施。     

广东省医用X射线诊断病人的受照剂量与分析

目的 了解广东省医用X射线诊断病人的受照剂量水平。方法 按照全国"九五"期间X射线诊断医疗照射的剂量水平调查方案进行。结果 得出门诊胸透等24种常见医用X射线诊断和CT检查的平均受照剂量。结论 其均值基本可代表广东省医用X射线诊断病人的受照剂量水平。     

Quality control--patient doses--guidance dose levels from diagnostic radiology in Tunisia

BACKGROUND: Radiation doses from diagnostic radiology are the most important exposure collective doses of the man. Entrance Surface Dose is one of the basic dosimetric quantities for measuring the patient dose and hence, an excellent tool for optimization purposes and for comparison with the international reference values. AIM: The aim of the study was to assess the delivred quantitis of rayon x to patients who undervent radiography; METHODS: For the first time in Tunisia the doses delivered to the patient undergoing the most common type of X ray examinations (chest, abdomen, lumbar spin) were performed in two university hospitals of Tunis. Entrance Surface Dose measurements were conducted using thermoluminescent dosimeters calibrated at the National Centre of Radiation Protection. Before measurements, quality control tests were carried out on each radiological equipment used for examinations. RESULTS: From this study of 112 patients, it was deduced that the obtained values were comparable to the internationally recommended guidance levels. The diagnostic guidance dose levels established for Tunis area are preliminary results. The study should therefore be implemented on a national scale as an approach to establish the national guidance levels.     

Nation-wide survey on radiation doses in diagnostic and interventional radiology in Switzerland in 1998

A nation-wide survey on radiation doses in diagnostic and interventional radiology was conducted in Switzerland in 1998 aiming at establishing their collective radiological impact on the Swiss population. The study consisted on the one hand of surveying the frequency of more than 250 types of examinations, covering conventional radiology, mammography, fluoroscopy, angiography, interventional radiology, CT, bone densitometry, conventional tomography and dental radiology. On the other hand, for each type of examination the associated patient dose was established by modeling. The results of this study show that about 9.5 million diagnostic and interventional examinations are performed annually in Switzerland (1.34 per caput) and that the associated annual collective dose is of the order of 7100 person.Sv (1.0 mSv per caput). Switzerland is similar to other European countries in terms of the frequency of examinations and the collective dose.     

Software for the estimation of foetal radiation dose to patients and staff in diagnostic radiology.

Occasionally, it is clinically necessary to perform a radiological examination(s) on a woman who is known to be pregnant or an examination is performed on a woman who subsequently discovers that she was pregnant at the time. In radiological examinations, especially of the lower abdomen and pelvis area, the foetus is directly irradiated. It is therefore important to be able to determine the absorbed dose to the foetus in diagnostic radiology for pregnant patients as well as the foetal dose from occupational exposure of the pregnant worker. The determination of the absorbed dose to the unborn child in diagnostic radiology is of interest as a basis for risk estimates from medical exposure of the pregnant patient and occupational exposure of the pregnant worker. In this paper we describe a simple computer program, FetDose, which calculates the dose to the foetus from both medical and occupational exposures of the pregnant woman. It also calculates the risks of in utero exposure, compares calculated doses with published data in the literature and provides information on the natural spontaneous risks. The program will be a useful tool for the medical and paramedical personnel who are involved with foetal dose (and hence risks) calculations and counselling of pregnant women who may be concerned about in utero exposure of their foetuses.     

Guidance levels for diagnostic radiology in Victoria. Radiation Safety Unit, Department of Human Services, Melbourne, Australia

Guidance levels for radiation doses in diagnostic radiology for average size patients have been developed for use in the state of Victoria. The guidance levels were determined from the results of surveys of patients in hospitals and private radiology centres in Victoria. Guidance levels have been developed for the following procedures: neonate chest AP; several plain film paediatric procedures; several plain film adult procedures; fluoroscopy equipment; and CT procedures. The guidance levels are compared with those recommended in other countries.     

Medical exposure of the population from diagnostic use of ionizing radiation in luxembourg between 1994 and 2002

A national evaluation on radiation doses from diagnostic procedures (x rays and nuclear medicine) was conducted in Luxembourg for the period 1994-2002 aiming at the estimation of the annual collective dose. The calculations were based on a survey of frequencies of more than 250 types of radiological examinations and included more than 425,000 patients. This evaluation ensured the practical implementation of Article 12 of the European Directive 97/43/EURATOM, which obliges the Member States to determinate the population dose from medical exposure. The results show an increase of the annual effective dose per capita from 1.59 mSv in 1994 to 1.98 mSv in 2002. The impact of computed tomography to dose received from medical use of radiation has dramatically increased in this time period. Luxembourg has one of the highest computed tomography examination rates compared to other health care level I countries. The following measures to minimize medical exposures were proposed in the study: medical physicists should have a more central role to play in patient dosimetry in interventional and diagnostic radiology, especially concerning computed tomography. Also, the implementation of an electronic "X-ray patient card" for all irradiated patients--except dental--and the use of the European referral criteria that give guidance and recommend investigations in various clinical settings can both help to decrease medical radiation exposures.     

A survey of radiation doses to adults from diagnostic radiology in Victoria.

This study examines doses to adult patients from diagnostic radiology. Measurements were made at 37 hospitals and private radiology centres in the state of Victoria. Skin entrance doses in air were measured for the exposure factors used by the radiographer for an average size patient for the following procedures: abdomen AP; pelvis AP; lumbar spine AP, lat, LSJ; and skull AP, lat. There was a large range of doses observed for each particular procedure. Factors contributing to the range of doses were identified. Guidance levels for adult radiography based on the third quartile values of the skin entrance dose have been adopted for use in Victoria.     

2016年南通市放射工作人员外照射个人剂量监测结果

目的 了解南通市放射工作人员职业外照射的剂量水平及分布情况,评价放射工作人员职业危害及防护效果,为放射防护管理工作提供科学依据。方法 使用RGD-3D热释光剂量仪对放射工作人员进行外照射个人剂量当量H_P（10）监测,职业类别包括诊断放射学、介入放射学、核医学、牙科放射学、放射治疗、工业应用等,采用全国放射卫生信息平台个人监测管理系统进行数据汇总统计。结果 南通市放射工作人员外照射人均年有效剂量为0.273 mSv/a,所有监测人员的年有效剂量均小于年剂量限值20 mSv,集体有效剂量为0.570人·Sv,人均年有效剂量以介入放射学（0.375 mSv/a）稍高,其次为核医学（0.316 mSv/a）,人数最多的诊断放射学为0.271 mSv/a,其余职业类别年有效剂量值均在较低水平;不同地区放射工作人员平均年有效剂量相差不大,人均年有效剂量海安县（0.418 mSv/a）较其他地区稍高;二甲医院以下医疗单位监测剂量值（0.361 mSv/a）要高于二甲医院及以上医疗单位（0.182 mSv/a）和工业企业（0.143 mSv/a）。结论 2016年南通市放射工作人员年有效剂量均处于较低水平,我市放射工作人员的放射防护条件良好,工作环境安全。     

2017—2018年松江区放射工作人员外照射个人剂量水平分析

目的 掌握松江区放射工作人员个人剂量水平,评价放射工作人员防护状况,进一步为放射工作人员的职业安全防护提供指导。方法 依据《职业性外照射个人监测规范》（GBZ 128—2016）,采用热释光剂量测量系统对从事放射工作的人员进行剂量监测,并对监测结果进行分析评价。结果 2017—2018年松江区共监测620人,人均年剂量当量为0.448 mSv·a⁻¹,两年集体剂量当量为277.514人·mSv,不同职业类别放射工作人员人均年剂量当量在0.259～1.276 mSv·a^-1,核医学人均年剂量当量高于其他四类（P < 0.05）,介入放射学高于放射诊断学、牙科诊断学和放射治疗（P < 0.05）。结论 松江区放射工作人员个人剂量水平远低于国家规定的限值20 mSv·a⁻¹,工作环境是相对安全的,但仍需提高放射工作人员防护意识加强自身防护。     

Doses to patients from diagnostic radiology in France

Reported here are results of a 1982 national survey in France to establish the collective effective dose equivalent associated with the main types of radiological examinations practiced annually in this country (except nuclear medicine, C.T. scans, dental radiology and mass chest screening). This report describes the methodology followed in achieving dose measurements either on an anthropomorphic phantom or directly on the patient, and it highlights the importance of the radiological procedures (number of x-ray films, fluoroscopy screening time, etc.) on the patient organ doses. The estimated collective effective dose equivalent associated with these radiological practices is 86,000 person-Sv, i.e., an individual effective dose equivalent of 1.58 mSv y-1; the genetically significant dose figure is 0.29 mSv and the collective red bone marrow dose due to 45 million x-ray exams practiced in France (1982) is 40,300 person-Sv, i.e. 0.74 mSv per inhabitant.     

河北省部分放射工作人员个人剂量监测与分析

目的调查河北省部分县级以上(含县级)医院放射防护工作情况。方法对2010年不同工种放射工作人员(248人)年人均剂量当量监测数值进行比较,个人剂量监测采用热释光剂量测量方法。结果放射工作人员年人均剂量当量范围为0.13～1.41 m〕mSv/a,平均值最低的工种为诊断放射学(0.13 mSv/a),最高工种为介入放射学(1.41 mSv/a)。介入放射学及医用加速器年人均有效剂量与诊断放射学相比较,差异有统计学意义(P0.01)。与牙科放射学比较,差异有统计学意义(P0.05)。结论河北省县级以上医院放射防护工作开展较好。但仍应进一步加强防护工作。对牙科X线机的防护也应加以重视。