数字摄影（DR）受检者的辐射剂量研究

发布时间：2018-04-19 15:01

本文选题：数字放射摄影 + 受检者　；参考：《济南大学》2014年硕士论文

【摘要】：目的通过对数字放射摄影（DR）检查中受检者辐射剂量的实际测量和调查，了解数字放射摄影检查中常见投照部位受检者的辐射剂量水平，为我国或山东省数字放射摄影受检者辐射剂量指导水平的制定提供基础数据。方法 1．现场测量：使用热释光剂量计（TLD）测量数字摄影受检者不同部位、不同投照方向的入射体表剂量（ESD）；使用剂量面积乘积仪测量数字摄影受检者不同投照部位、不同投照方向的剂量面积乘积（DAP）；使用现场调查表记录受检者的基本信息及投照条件，包括管电压、毫安秒等。 2．实验室测读：采用RGD-3B型热释光剂量仪测量热释光剂量计的读数，，计算出患者入射体表剂量。 3．有效剂量E估算：利用测量的DAP值，通过基于蒙特卡罗（Monte Carlo）计算方法剂量估算软件（RefDose）进行受检者有效剂量的估算。结果 1．投照条件的使用情况：不同投照部位所用的kV和mAs的差别均具有统计学意义（F=37.05、26.02，P0.05），即使是同台设备、同种投照部位，kV和mAs也都有较大差异，但通过后处理技术均能获得满意的图像。 2．受检者辐射剂量水平：不同投照部位受检者入射体表剂量的差别具有统计学意义（F=33.47，P0.05），以腰椎侧位（LAT）最高，均数为4.62mGy/次，腰椎后前位（PA）次之，均数为2.46mGy/次，胸部（PA）最低，均数为0.28mGy/次；不同投照部位受检者剂量面积乘积的差别具有统计学意义（F=24.68，P0.05），以腰椎（LAT）最高，均数为2.26Gy·cm2，腹部前后位（AP）次之，均数为2.04Gy·cm2，颈椎（PA、LAT）最低，均数分别为0.28Gy·cm2和0.29Gy·cm2；不同投照部位所致受检者有效剂量E的差别具有统计学意义（F=43.19，P0.05），以腹部（AP）最高，均数为0.591mSv，高于腰椎（LAT）的0.311mSv，头颅（LAT）最低，均数为0.013mSv。 3．与传统X射线摄影的比较：常见投照部位，包括胸部（PA）、胸部（LAT）、腰椎（PA）、腰椎（LAT）、腹部（AP）、骨盆（AP）受检者入射体表剂量均低于传统X射线摄影的水平（t=-5.44、-9.99、-15.87、-17.75、-8.50、-3.22，P0.05）。 4．与国内水平的比较：本次调查的胸部正、侧位片和脊柱（包括颈椎、胸椎、腰椎）正、侧位片的受检者入射体表剂量高于上海市的0.20mGy/次、0.72mGy/次、1.02mGy/次、1.63mGy/次（t=6.00、3.08、8.43、4.45，P＜0.05）； 5．与国外水平的比较：除腹部（AP）外，本次调查的胸部（PA）、胸部（LAT）、腰椎（PA）、腰椎（LAT）、骨盆（AP）受检者入射体表剂量均高于国外同类检查的水平（t=16.02、9.16、6.25、6.54、2.53，P0.05）；关于有效剂量E的估算结果，除腰椎（PA）以外，胸部（PA）、胸部（LAT）、腰椎（LAT）、腹部（AP）、骨盆（AP）的受检者有效剂量E均高于国外估算结果（t=7.48、8.58、5.62、7.51、2.96，P0.05）。结论本研究通过数字放射摄影受检者辐射剂量的测量与调查发现，与传统X射线摄影相比，受检者辐射剂量虽然有所降低，但比国外以及国内发达地区受检者接受的辐射剂量相对要高，鉴于DR摄影有较高的曝光宽容度，投照条件、受检者辐射剂量存在很大的差异，往往通过后处理技术可以获得满意的诊断影像，预示着在数字放射摄影检查中，需要制定受检者辐射剂量指导水平，同时加强放射防护最优化，以尽可能降低受检者辐射剂量。初步建议数字摄影中，头颅PA、头颅LAT、胸部PA、胸部LAT、腹部AP、骨盆AP、颈椎PA、颈椎LAT、胸椎PA、胸椎LAT、腰椎PA、腰椎LAT典型成年受检者辐射剂量的指导水平分别为1.1、0.55、0.36、0.76、2.0、0.68、0.63、2.0、3.2、3.2、5.0、1.4mGy/次。
[Abstract]:objective
Through the actual measurement and investigation of the radiation dose of the subjects in the digital radiography (DR), the radiation dose level of the subjects in the digital radiography examination is understood, which provides the basic data for the setting of the radiation dose guidance level of the subjects in the digital radiography of our country or Shandong province.
Method
1. field measurement: using a thermoluminescence dosimeter (TLD) to measure the incident body surface dose (ESD) of different parts of the subjects and the direction of exposure, and the dose area multiplicative instrument to measure the dose area multiplicative (DAP) of the subjects of digital photographers in different directions, and to record the base of the subjects using a field questionnaire. This information and projection conditions include tube voltage, Ma An second and so on.
2. laboratory reading: the RGD-3B thermoluminescence dosimeter was used to measure the readings of thermoluminescence dosimeters, and the body surface dose of the patient was calculated.
3. effective dose E estimation: using the measured DAP value, the dose estimation software based on the Monte Carlo (Monte Carlo) calculation method (RefDose) was used to estimate the effective dose of the subjects.
Result
The use of 1. exposure conditions: the differences of kV and mAs used in different shooting parts were statistically significant (F=37.05,26.02, P0.05). Even the same equipment, the same location, kV and mAs were also different, but the post-processing technology could get a satisfactory image.
The radiation dose level of 2. subjects: the difference of the incidence of incident body surface dose in the subjects with different exposure sites was statistically significant (F=33.47, P0.05), the highest of the lumbar lateral position (LAT), the average number of 4.62mGy/ times, the posterior lumbar anterior position (PA), the number of 2.46mGy/ times, the lowest chest (PA), the 0.28mGy/ times, and the dose area of the different exposure sites. The difference in product was statistically significant (F=24.68, P0.05), the highest of the lumbar spine (LAT), the average number of 2.26Gy. Cm2, the second of the abdomen (AP), the number of 2.04Gy. Cm2, and the lowest level of the cervical vertebra (PA, LAT). With the highest abdominal mass (AP), the mean was 0.591mSv, higher than that of the lumbar spine (LAT) 0.311mSv, and the head (LAT) was the lowest, with a mean of 0.013mSv..
3. compared with the traditional X ray photography, the incidence of incident location, including the chest (PA), the chest (LAT), the lumbar (PA), the lumbar (LAT), the abdomen (AP), and the pelvic (AP) subjects were lower than those of the traditional X ray photography (t=-5.44, -9.99, -15.87, -17.75, -17.75).
4. compared with the domestic level: the chest positive, lateral film and spinal column (including cervical vertebra, thoracic vertebra, and lumbar vertebra) were compared with the 0.20mGy/ times in Shanghai, 0.72mGy/ times, 1.02mGy/ times, 1.63mGy/ times (t=6.00,3.08,8.43,4.45, P < 0.05).
5. compared with the foreign level: except for the abdominal (AP), the chest (PA), the chest (LAT), the lumbar (PA), the lumbar (LAT), and the pelvis (AP) subjects were all higher than those of the foreign counterparts (t=16.02,9.16,6.25,6.54,2.53, P0.05), and the results of the effective dose of E, except for the lumbar (PA), chest (PA), and chest (LAT). The effective dose E of the lumbar spine (LAT), abdomen (AP), and pelvis (AP) was higher than that of the foreign countries (t=7.48,8.58,5.62,7.51,2.96, P0.05).
conclusion
In this study, the measurement and investigation of the radiation dose of the subjects of digital radiography showed that compared with the traditional X ray photography, the radiation dose of the subjects was lower, but the radiation dose received by the examiners in the developed areas was higher than that of the foreign and domestic developed areas. In view of the higher exposure tolerance of the DR photography, the exposure conditions and the radiation of the subjects were radiated. There is a great difference in dose, and a satisfactory diagnostic image can be obtained through post-processing techniques. It indicates that in digital radiography, the level of radiation dose guidance of the subjects should be formulated and the optimization of radiation protection is strengthened so as to reduce the amount of radiant agents of the subjects as much as possible.
Preliminary suggested Digital Photography: head PA, head LAT, chest PA, chest LAT, abdominal AP, pelvic AP, cervical PA, cervical LAT, thoracic vertebra PA, thoracic vertebra LAT, and lumbar PA.

【学位授予单位】：济南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R814.2

【参考文献】