不断完善的医用X射线摄影诊断指导水平
Continuous Improvement of the Diagnostic Reference Levels for Medical X-Ray Radiography
DOI: 10.12677/MD.2013.31001, PDF, HTML, XML,  被引量    国家自然科学基金支持
作者: 李鹏, 卓维海*, 陈波, 易艳玲：复旦大学放射医学研究所，上海
关键词: 医疗照射；放射防护；指导水平；入射体表剂量；Medical Exposure; Radiation Protection; Reference Level; Entrance Surface Dose
摘要: 为不断完善医用X射线诊断的医疗照射指导水平(以下简称“指导水平”)提供参考，综述分析世界各地在不同年代建立的指导水平情况。按成年人和儿童分类，以医用X射线诊断摄影为例，比较分析指导水平的差异及其变化趋势。结果显示不同国家、组织或地区已制订的指导水平的种类及其相应量值不尽相同，特别是在部分发达国家，指导水平的种类日趋增多、剂量参考水平越来越严。这对完善或更新我国医疗照射指导水平具有很高的指导意义。 To provide references for improving the diagnostic reference level (DRL) for medical X-ray diagnostic radi- ography, the recommended dose levels all over the world in different years were reviewed and analyzed. Grouped the examinees/patients into adults and children and taken the medical X-ray diagnostic photography as an example, the ref- erence levels and their trends were compared and analyzed. The results showed that both the types and their values of DRLs varied from different countries, organizations or regions. Especially in some developed countries, the types of DRLs are increasing, and the dose reference levels are getting strict. The findings of this study are useful for improving the DRLs of medical exposure in our country.

文章引用：李鹏, 卓维海, 陈波, 易艳玲. 不断完善的医用X射线摄影诊断指导水平[J]. 医学诊断, 2013, 3(1): 1-5. http://dx.doi.org/10.12677/MD.2013.31001

参考文献

[1] UNSCEAR. Sources and effects of ionizing radiation, Vol. I: Sources. New York, 2000.
[2] D. Hart, B. F. Wall. Radiation exposure of the UK population from medical and dental X-ray examinations: NRPB-W4. Chil- ton: National Radiological Protection Board, 2002.
[3] 高林峰, 姚杰, 郑钧正等. 上海市2007年X射线诊断的医疗照射应用频率及其分布[J]. 环境与职业医学, 2009, 26(6): 532-536.
[4] 郑钧正, 郭常义, 吴凡. 让医疗照射更好地造福于民[J]. 环境与职业医学, 2009, 6: 525-527.
[5] K. Matthews, P. C. Brennan. The application of diagnostic ref- erence levels: General principles and an Irish perspective. Radi- ography, 2009, 15: 171-178.
[6] 郑钧正, 卓维海. 不断完善与推广应用医疗照射的指导水平[J]. 医学研究杂志, 2007, 36(12): 4-6.
[7] 朱志贤, 郑钧正, 陈峰等. 放射诊断医疗照射指导水平的确定方法[J]. 中国辐射卫生, 2004, 13(2): 83-87.
[8] 刘长安. 关于医疗照射指导水平[J]. 中国医疗器械信息, 2009, 15(5): 81-84.
[9] ICRP. The 2007 recommendations of the international commis- sion on radiological protection. Oxford: Elsevier, 2007.
[10] B. F. Wall. Implementation of DRLs in the UK. Radiation Pro- tection Dosimetry, 2005, 114(1-3): 183-187.
[11] D. A. Johnston, P. C. Brennan. Reference dose levels for patients undergoing common diagnostic X-ray examinations in Irish hospitals. British Journal of Radiology, 2000, 73(868): 396-402.
[12] I. I. Suliman, E. H. Elshiekh. Radiation doses from some com- mon paediatric X-ray examinations in Sudan. Radiation Protec- tion Dosimetry, 2008, 132(1): 64-72.
[13] D. Hart, M. C. Hillier and B. F. Wall. Doses to patients from me- dical X-ray examinations in the UK-2000 review: NRPB-W14. Chilton: NRPB, 2002.
[14] K. H. Ng, P. Rassiah, H. B. Wang, et al. Doses to patients in rutine X-ray examination in Maulaysia. The British Journal of Radiology, 1998, 71: 654-660.
[15] AEA安全丛书N0.115. 国际电离辐射防护和辐射源安全的基本安全标准[M]. 维也纳: 国际原子能机构, 1997.
[16] 中华人民共和国国家质量监督检验检疫总局. GB 18871-2002,电离辐射防护与辐射源安全基本标准[S]. 北京: 中华人民共和国国家质量监督检验检疫总局, 2006.
[17] D. Hart, M. C. Hillier and B. F. Wall. National reference doses for common radiographic, fluoroscopic and dental X-ray exami- nations in the UK. British Journal of Radiology, 2009, 82: 1-12.
[18] Y. Kim, J. Choi, C. Kim, et al. Patient dose measurements in diag- nostic radiology procedures in Korea. Radiation Protection Do- simetry, 2007, 123(4): 540-545.
[19] D. Hard, M. C. Hillier and B. F. Wall. Doses to patients from ra- diographic and fluoroscopic X-ray imaging procedures in the UK-2005 review. Chilton: Health Protection Agency, 2007.
[20] G. Compagnone, L. Pagan and C. Bergamini. Local diagnostic reference levels in standard X-ray examinations. Radiation Pro- tection Dosimetry, 2005, 113(1): 54-63.
[21] A. Aroua, A. Besancon, I. Buchillier-Decka, et al. Adult refer- ence levels in diagnostic and interventional radiology for tem- porary use in Switzerland. Radiation Protection Dosimetry, 2004, 111(3): 289-295.
[22] J. Ziliukas, G. Morkunas. Results of a patient dose survey on diagnostic radiology in Lithuania. Radiation Protection Dosi- metry, 2005, 114(1-3): 172-175.
[23] J. Ziliukas, L. Krynke and A. Urboniene. Management of patient doses and diagnostic reference levels in X-ray radiography in Lithuania. Radiation Protection Dosimetry, 2010, 139(1-3): 313- 316.
[24] M. Asadinezhad, M. T. B. Toosi. Doses to patients in some rou- tine diagnostic X-ray examinations in Iran: Proposed the first Iranian diagnostic reference levels. Radiation Protection Dosi- metry, 2008, 132(4): 409-414.
[25] M. B. Freitas, E. M. Yoshimura. Diagnostic reference levels for the most frequent radiological examinations carried out in Brazil. Revista Panamericana de Salud Pública/Pan American Journal of Public Health, 2009, 25(2): 95-104.
[26] O. A. Osibote, A. C. P. de Azevedo. Estimation of adult patient doses for common diagnostic X-ray examinations in Rio de Ja- neiro Brazil. Physica Medica, 2008, 24(1): 21-28.
[27] UNSCEAR. Sources and effects of ionizing radiation, Vol. I: UNSEAE 2008 report to the general assembly with scientific annexes. New York, 2010.
[28] K. A. Gogos, E. N. Yakoumakis, I. A. Tsalafoutas, et al. Radia- tion dose considerations in common paediatric X-ray examina- tions. Pediatric Radiology, 2003, 33(4): 236-240.
[29] A. U. Sonawane, K. J. Sunil, M. Singh, et al. Suggested diagno- stic reference levels for paediatric X-ray examinations in India. Radiation Protection Dosimetry, 2011, 147(3): 423-428.
[30] European Commission. Radiation protection 109: Guidance on diagnostic reference levels (DRLs) for medical exposures. Euro- pean Commission, 1999.