神経ブロック療法における術者手指被曝低減の試み : Under Table方式とOver Table方式の比較

概要

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Fluoroscopy-guided intervention of the lumbar spine, such as nerve block, plays an important role in the management of disc hernia patients. However, irradiation of operators' fingers remains a problem even with careful collimation and operation, especially when performed by non-radiologists. We compared the irradiation doses of under-table and over-table fluoroscopy systems, and we discuss the most advantageous method of reducing irradiation. The effectiveness and conditions of use of lead protection gloves were also evaluated. Skin dose was monitored using polymethyl methacrylate (PMMA) and an electronic dose meter. The skin doses of over- and under-table fluoroscopy were compared using C-arm fluoroscopy. Finger irradiation dose with 0.03 mmPb protection gloves was also measured. The under-table method reduced skin dose by 95 % compared with the over-table method. Thicker PMMA resulted in a higher rate of irradiation reduction. Protection gloves reduced radiation dose by half, although this reduction was cancelled when automatic brightness control (ABC) was utilized. Under-tube fluoroscopy was superior to over-tube fluoroscopy in reducing irradiation to the fingers.
社団法人日本放射線技術学会の論文
2004-03-20