SummaryMedical staffs like radiological technologists, doctors, and nurses are at an increased risk of exposure to radiation while assisting the patient in a position or monitor contrast medium injection during computed tomography (CT). However, methods to protect medical staff from radiation exposure and protocols for using radiological protection equipment have not been standardized and differ among hospitals. In this study, the distribution of scattered X-rays in a CT room was measured by placing electronic personal dosimeters in locations where medical staff stands beside the CT scanner gantry while assisting the patient and the exposure dose was measured. Moreover, we evaluated non-uniform exposure and revealed effective techniques to reduce the exposure dose to medical staff during CT. The dose of the scattered X-rays was the lowest at the gantry and at the examination table during both head and abdominal CT. The dose was the highest at the trunk of the upper body of the operator corresponding to a height of 130 cm during head CT and at the head corresponding to a height of 150 cm during abdominal CT. The maximum dose to the crystalline lens was approximately 600 Sv during head CT. We found that the use of volumetric CT scanning and X-ray protective goggles, and face direction toward the gantry reduced the exposure dose, particularly to the crystalline lens, for which lower equivalent dose during CT scan has been recently recommended in the International Commission on Radiological Protection Publication 118.

To decrease radiation exposure to medical staff performing angiography, the dose distribution in the angiography was calculated in room using the particle and heavy ion transport code system (PHITS), which is based on Monte Carlo code, and the source of scattered radiation was confirmed using a tungsten sheet by considering the difference shielding performance among different sheet placements. Scattered radiation generated from a flat panel detector, X-ray tube and bed was calculated using the PHITS. In this experiment, the source of scattered radiation was identified as the phantom or acrylic window attached to the X-ray tube thus, a protection curtain was placed on the bed to shield against scattered radiation at low positions. There was an average difference of 20% between the measured and calculated values. The H*(10) value decreased after placing the sheet on the right side of the phantom. Thus, the curtain could decrease scattered radiation.

A 57-year-old man with coronary bypass surgery experienced spontaneous rupture of a vein graft 16 months following his operation. Multislice computed tomography revealed a perforation of the saphenous vein graft to the obtuse marginal branch. 3D imaging was useful for diagnosis and in planning treatment. Hesitation to perform surgical treatment occurred due to inflammation in the patient, therefore we successfully implanted a polytetrafluoroethylene-covered stent to occlude the site of perforation. The use of a covered stent for a patient showing clear leakage of dye during angiography should be considered as an alternative to surgical intervention for a ruptured vein.

No abstract