光激發光劑量計於腹部電腦斷層掃描動靜脈相之劑量評估

Optically Simulated Luminescent Dosimeter Evaluated Radiation Dose of Arteriovenous Phase in Abdominal Computer Tomography

林佳陽(Cha-Yang Lin) ； 陳柏仁(Po-Jen Chen) ； 白宗庭(Tsung-Ting Pai) ； 王昱筌(Yu-Chuan Wang) ； 林招膨(Jao-Perng Lin)

《台灣應用輻射與同位素雜誌》 14卷3期 (2018/09) Pp. 1599-1606

摘要

在台灣臨床醫師利用電腦斷層做為腹部疾病的診斷與鑑別。對於腹痛患者，醫師通常會開立腹部X光或站立式胸部X光檢查來進行第一步的診斷，而X光檢查無法進行確診之病患，腹部電腦斷層攝影（Computer Tomography, CT）則是最快速且基本的診斷工具。通常一般腹部CT掃描之掃描組數為各掃描一組不打顯影劑以及打顯影劑後（靜脈相）來做為診斷依據。但現代醫學，醫師對於所要獲取的醫學影像越來越要求精細，現行許多的醫學中心皆改為腹部CT 掃描組數為加掃一組打顯影劑（動脈相）來獲取病患更多的疾病診斷依據。本研究利用原廠水假體及光激發光劑量計（Optically Stimulated Luminescence Dosimeter, OSLD）來評估腹部CT掃描動靜脈相病患所增加的輻射劑量及風險評估。結果測得危急器官胃劑量相差0.24 mGy，結腸劑量相差0.34 mGy，肝劑量相差0.23 mGy。根據ICRP 103號報告加總後之全身有效劑量兩者相差0.079 mSv，再根據ICRP 60號報告之機率效應風險計算輻射風險，腹部CT掃描加做動脈相後提高的機率效應風險為0.02×10^(-5) Sv^(-1)。因此腹部CT掃描為了幫助醫師取得更多的診斷依據而增加一組動脈相影像，患者所增加的輻射劑量皆在法規規定的安全範圍內。

關鍵字

光激發光劑量計 ； 腹部電腦斷層攝影 ； 靜脈相 ； 動靜脈相 ； 輻射風險

並列摘要

The clinician depends on computer tomography to diagnose abdominal disease. Doctors often order abdomen, KUB or standing chest x-ray to diagnose in patients with abdominal disease, but x-ray can't accurate diagnosis the patients. The abdominal computer tomography is the fastest and basic diagnostic tool. There are two protocols in abdominal CT. The non-contrast and contrast (vein phase) are used to diagnose abdominal disease. However, doctors want to detail images for diagnosis. Many medical center hospital change protocols from abdominal computer tomography that add a protocol of contrast phase (artery phase) for obtaining more diagnostic information. In this study, we used water phantom and optically Stimulated Luminescence Dosimeter, OSLD to evaluate the radiation dose and risk assessment of patients in arteriovenous phase abdominal computer tomography. The results showed that the risk of organ stomach dose difference was 0.24 mGy, the colon dose difference was 0.34 mGy, and liver dose difference was 0.23 mGy. According to the ICRP report No.103, the total effective does difference was 0.079 mSv. According to the ICRP report No.60, probability effect of the risk, calculate the radiation risk of artery phase phases. The risk of increased odds of an abdominal CT scans plus arterial phase is 0.02×10-5Sv-1. Therefore, in order to help doctors obtain more diagnostic evidence, abdominal computer tomography increases a protocol of arterial phase. The patient's increased radiation dose is safety limits in the regulations.

並列關鍵字

OSLD ； Abdominal Computer Tomography ； Venous Phase ； Arteriovenous Phase ； Radiation Dose