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目的通过采用DSA机自带的Area Exposure Product Meter穿透电离室型剂量监测系统测量剂量面积乘积值(DAP)以及参考点的累积剂量(CD)值,用Monte Carlo转换系数分别估算出患者的有效剂量(ED)及入射体表剂量率(ESDR),测量头部放射介入诊疗活动中患者的基本剂量学参数,开展放射介入诊断参考水平调查。方法数据处理采用SPSS v13.0版本,参照ICRP第103号出版物和WS/T189-1999《医用X射线诊断设备影像质量控制检验规范》及附录中提供的方法进行。结果头部全脑血管治疗、全脑血管造影和脑血管栓塞治疗DAP的75%分位数分别为124.9、123.4、185.3 Gy.cm2;其中单次操作ED>10 mSv在各组中所占比例分别为36.3%、49.3%、55.0%;ESDR的超标率分别为1.9%、1.4%、10.0%结论 DAP的75%分位数可作为医疗照射相应放射介入操作的诊断参考水平(diagnostic reference level,DRL),为了确定某一地区某一特定操作类型的DRL值还需要收集大量的调查数据和开展剂量学模型的验证工作。
OBJECTIVE To estimate the effective dose (DAP) of dose area and the cumulative dose (CD) value of reference point by using the area exposure product meter penetrating ionization chamber type monitor system of DSA machine, Dose (ED) and incident body surface dose rate (ESDR) were measured to measure the basic dosimetry parameters of the patients involved in the head radiation interventional diagnosis and treatment activities, and to carry out the investigation of radiation intervention diagnostic reference level. Method Data processing was performed using the SPSS v13.0 release, with reference to ICRP Publication No. 103 and WS / T 189-1999 “Specifications for Inspection of Image Quality Control for Medical X-Ray Diagnostic Equipment” and appendix. Results The 75% quantiles of DAP were 124.9, 123.4 and 185.3 Gy.cm2 respectively in patients with head cerebral thrombosis, total cerebral angiography and cerebral embolism. Among them, the proportion of single operation ED> 10 mSv in each group (36.3%, 49.3%, 55.0% respectively). The rates of ESDR were 1.9%, 1.4%, 10.0% respectively. Conclusion The 75% quantiles of DAP can be used as the diagnostic reference level for medical radiation corresponding interventional radiological procedures, DRL), in order to determine the DRL value for a particular type of operation in a particular area, large amounts of survey data and validation of dosimetric models are also required.