CT引导介入操作中患者有效辐射剂量的研究

目的探讨CT引导下各类介入操作中患者接受的有效辐射剂量。方法回顾性分析近2年来我科CT引导下介入诊断和治疗259例次患者的检查资料。介入操作包括穿刺活检、引流、射频消融、经皮瘤内无水乙醇注射术、放射性¹²⁵Ⅰ粒子植入术、腹腔神经丛阻滞术等6种方法。浏览PCAS系统上的医学信息和图像,并记录患者所接受的介入诊疗方式、扫描时间、扫描次数、总毫安秒、CT剂量指数、剂量长度乘积。有效辐射剂量根据国际放射防护委员会（ICRP）制定的蒙特卡罗有效剂量转换公式进行计算。结果放射性¹²⁵Ⅰ粒子植入术、经皮瘤内无水乙醇注射术、射频消融术、腹腔神经丛阻滞术、引流、活检平均有效辐射剂量分别是（25.62±10.43）mSv、（19.02±7.35）mSv、（18.69±6.39）mSv、（16.22±5.60）mSv、（10.66±4.51）mSv和（9.67±3.81）mSv,粒子植入术的有效辐射量明显高于其他介入操作,差异有统计学意义。结论 CT引导下单次介入操作有效辐射剂量相对较小,引起辐射损伤及后续并发症的危险小,但多次介入治疗累积的有效辐射剂量可能会较大,需要引起一定的重视。

Radiation dose received by the patients in performing CT-guided interventional procedures

Objective To determine the effective radiation dose to patients undergoing CT-guided interventional procedures.Methods A total of 259 patients undergoing CT-guided interventional procedures in resent 2 years were included in this retrospective data analysis study.All patients underwent one of the following six procedures:biopsy,drain,radiofrequency ablation,percutaneous ethanol injection to tumor,¹²⁵I seed implantation,percutaneous neurolytic block of celiac plexus.Medical records and images stored in PACS were retrospectively reviewed in order to obtain the following data:the type of CT -guided interventional procedure,the scanning time,the scanning numbers,the total dose of mAs and the total does-length product. Effective dose was calculated by multiplying does-length product（DLP） by conversion factor（K factor） using Monte Carlo organ dose coefficients for intermittent mode.Results The mean plus SD effective doses for ¹²⁵I seed implantation,percutaneous ethanol injection to tumor,radiofrequency ablation,percutaneous neurolytic block of celiac plexus,drain and biopsy procedures were（25.62±10.43） mSv,（19.02±7.35） mSv, （18.69±6.39） mSv,（16.22±5.60） mSv,（10.66±4.51） mSv,（9.67±3.81） mSv,respectively.The radiation dose received by the patient in ¹²⁵I seed implantation procedure was significantly higher than those in any other interventional procedures.Conclusion Single CT -guided interventional procedure may not produce too much radiation to patient,but the cumulated effective radiation dose produced by many times of CT-guided interventional treatments might be considerably higher to patients.