不同版本国际放射防护委员会建议组织器官权重因子对心脏介入诊疗所致有效剂量的影响

目的 对比采用国际放射防护委员会(ICRP)60和ICRP 103组织器官权重因子计算冠状动脉血管造影术(CAG)及经皮穿刺腔内冠状动脉成形术(PCI)所致有效幅射剂量的变化.方法 采用在ART仿真人体辐照体模(fluke biomedical)躯干部分布放热释光剂量计的方法获得器官剂量,再将器官剂量按照不同版本ICRP组织器官权重因子加权求和获得有效剂量.分析有效剂量变化趋势及原因.同时计算有效剂量与剂量面积乘积(DAP)转换系数.结果 ICRP 103对组织器官权重因子进行调整后带来了有效剂量的增加:CAG(6.88%)和PCI(8.46%).对于CAG、PCI诊疗过程,权重因子的变化带来女性有效剂量的变化为7.25%(8.76%),男性有效剂量的变化为6.51%(8.17%);有效剂量对DAP的转换系数也从0.10(0.13)变为0.11(0.14).结论 ICRP 103对组织器官权重因子的调整导致了CAG和PCI诊疗过程所致患者器官剂量的增加,对于有效剂量增加幅度PCI略高于CAG,女性患者略高于男性患者.有效剂量的增加有两方面原因:器官权重因子变化小而器官当量剂量大和器官当量计晕小但器官权重因子变化大.有效剂量和DAP之间转换系数的变化表明在介入放射工作中用转换系数估算患者有效剂量时要考虑新版本ICRP对组织器官权重因子的调整.

Effective radiation dose in cardiac interventional procedures: the difference between ICRP publication 60 and publication 103

Objective to compare the calculated effective radiation dose variations in cardiac interventional procedures of coronary angiography (CAG) and percutaneous transluminal coronary angioplasty (PCI) by using the different tissue weighting factors recommended by ICRP Publication 60 with that recommended by ICRP Publication 103. Methods Measurements of organ doses were carried out with an anthropomorphic phantom equipped with thermoluminecent dosimetry. The effective radiation doses were separately calculated using the tissue weighting factors provided by ICRP 60 and provided by ICRP 103, and the results obtained from ICRP 60 were compared with that obtained from ICRP 103. Conversion factors of effective, radiation dose to dose area product (DAP) were also calculated according to different publication.Results The variations in the effective dose were 6.88% for CAG and 8.46% for PCI. The effective dose variations in CAG and PCI were. 7.25% and 8.76% for female and were 6.51% and 8.17% for male,respectively. The effective conversion factors of DAP were. 0.10 ～ 0.11 and 0.13 ～ 0.14 for CAG and PCI,respectively, according to ICRP 60 and 103. Conclusion The variation of conversion factors of effective dose indicates that in making estimation of effective radiation dose. by using the widely accepted conversion factors, the adjustment of organ weighting factors recommended by ICRP 103 should be considered.