心血管病介入诊疗程序中第一术者有效剂量估算方法的比较研究

目的 通过模拟实验测量，比较国际辐射防护委员会（ICRP）139号报告推荐的4种单双剂量计算法对估算心血管介入诊疗程序中第一术者有效剂量之间的差异，以探讨这4种算法对介入诊疗场景的适用性。方法 模拟第一术者的男性躯干模体穿戴铅衣和铅围脖，在其体内布放热释光探测器，在其铅衣内外布放热释光个人剂量计，模拟心血管病介入诊疗场景，通过模拟测量得到的器官剂量计算第一术者的有效剂量，与通过个人剂量计及4种单双剂量计算法得到的结果进行比较。结果 在本实验条件下，由模拟测量计算得到的有效剂量为0.581 mSv；而用Swiss ordinance法、McEwan法、Von Boetticher法与Martin-Magee法估算得到的有效剂量分别为0.667、0.484、0.485和0.726 mSv，与模拟测量得到的有效剂量的相对偏差分别为14.8%、-16.7%、-16.5%和24.9%。结论 4种计算方法得到第一术者有效剂量与模拟测量结果均有较大的差异；从辐射防护观点出发，推荐使用Swiss ordinance法开展心血管病介入诊疗程序中第一术者的个人剂量监测。

A comparative experimental study of dosimetry algorithms for estimating the interventional radiology staff's effective dose in the cardiovascular interventional procedure

Objective To compare, through experimental measurements, the differences between four kinds of single and double dosimetry algorithms recommend by ICRP 139 Publication in estimating interventional radiology staff''s effective dose, with aim to realize the applicability of algorithms for cardiovascular interventional diagnosis and treatment in China. Methods Measurements of organ doses were carried out with an anthropomorphic phantom equipped with thermoluminecent dosimetry and dressed with lead apron and lead collar. The effective doses were calculated using the tissue weighting factors. Meanwhile, the staff''s effective doses were also obtained by the use of four kinds of single and double dosimetry algorithms. The later four effective doses were compared with those obtained with phantom methode. Results The effective doses were 0.581 mSv for phantom method, 0.667 mSv for Swiss ordinance''s algorithm, 0.484 mSv for McEwan''s algorithm, 0.485 mSv for von Boetticher''s algorithm and 0.726 mSv for Martin-Magee''s algorithm, in ICRP 139 report respectively. The relative deviations to the results of experimental measurement were 14.8% for Swiss ordinance''s algorithm, -16.7% for McEwan''s algorithm, -16.5% for von Boetticher''s algorithm and 24.9% for Martin-Magee''s algorithm, respectively. Conclusions There are great differences between the effective doses of the first operator obtained by four dosimetry algorithms and the simulated result. From the point of view of radiation protection, it is recommended to use the Swiss ordinance''s algorithm to carry out individual monitoring of the first operator in the cardiovascular interventional procedures.