神经介入手术中患者峰值皮肤剂量水平研究

目的 获得神经介入手术中患者峰值皮肤剂量数据（PSD），评估患者确定性效应发生风险。方法 使用Gafchromic XR RV3胶片采集北京市某三级甲等医院神经介入手术患者的峰值皮肤剂量，主要研究血管栓塞术、血管成形术、血管造影术等3种常见的神经介入手术。使用Epson Expression 10000XL扫描仪扫描胶片，利用ImageJ和Film QA Pro^TM 2014软件测量和分析胶片。结果 共采集49例神经介入手术患者的峰值皮肤剂量数据，包括血管栓塞术23例、血管成形术14例、血管造影术12例。PSD ≥ 2 Gy患者20例，其中血管栓塞术15例，血管成形术5例。血管造影术患者的PSD均<2 Gy。部分神经介入手术患者的峰值皮肤剂量超过国际放射防护委员会（ICRP）第118号报告中的确定性效应剂量阈值。结论 神经介入手术存在发生确定性效应的风险，建议针对风险较高的患者进行随访观察，及时了解其辐射损伤情况和后续诊治。

Peak skin dose measurements for patients in neuro-interventional procedures using radiochromic film

Objective To determine the peak skin dose (PSD) to patients from neuro-interventional procedures and evaluate the risk of the deterministic effect. Methods Gafchromic XR RV3 films were used in a level A tertiary hospital in Beijing to measure the patients'' PSD from neuro-interventional procedures, mainly three common types of procedures, including vascular embolization, vascular angioplasty and vascular angiography. The films were scanned by Epson Expression 10000XL, read by ImageJ software, and analyzed by Film QA Pro^TM 2014 software. Results PSD was measured in 23 embolizations,14 stentings and 12 arteriography. There were 20 patients whose PSD were equal or greater than 2 Gy, including 15 in vascular embolization and 5 in angioplasty. The PSDs to patients in cerebral arteriography were all below 2 Gy. The PSDs to some of the patients were higher than the threshold for deterministic effect recommended by ICRP Publication 118. Conclusions There is a risk of deterministic effect in neurointerventional procedures. It is suggested that the patients be followed up to observe their radiation injury as well as to know in time the subsequent diagnosis and treatment.