우리나라의 골반 및 요추 엑스선검사에서의 환자선량 권고량

Diagnostic Reference Levels for Patient Radiation Doses in pelvis and Lumbar spine Radiography in Korea

목 적 : 골반 및 요추 엑스선검사는 진단 엑스선검사 중 생식선을 포함하고 있고 환자가 받는 방사선량이 많은 검사로서 우리나라에는 골반 및 요추 엑스선검사에서의 환자선량 권고량이 마련되어 있지 않다. 따라서 국내 의료기관에서 골반 및 요추 엑스선검사 시 환자가 받는 방사선량을 측정하여 평가하고 골반 및 요추 엑스선검사에서 환자의 방사선 방어 최적화를 위한 환자선량 권고량을 확립한다. 방 법 : 전국 125개 의료기관에서 골반 전후면 촬영, 요추 전후면 및 측면 촬영시 촬영조건과 진단영상정보를 조사 분석하고 환자가 받는 입사표면선량을 유리선량계를 사용하여 측정 평가한다. 환자가 받는 방사선량 중 제3사분위값에 해당하는 선량값을 의료기관에 권고할 골반 및 요추 엑스선검사에서의 환자선량 권고량으로 확립한다. 결 과: 전국 125개 의료기관에서 골반 및 요추 엑스선검사 시 진단영상정보를 조사하고 환자가 받는 입사표면선량을 측정한 결과 골반 전후면 엑스선검사에서는 관전압이 60~97kVp, 평균 75kVp를 사용하였고, 관전류-시간곱(mAs)는 8~123mAs, 평균 29.7mAs를 사용하였다. 요추 전후면 및 측면 엑스선검사에서는 관전압을 각각 65~100kVp, 평균 78kVp와 70~109kVp, 평균 87kVp를 사용하였고 mAs도 각각 10~100mAs, 평균 35.2mAs와 8.9~300mAs, 평균 64.1mAs를 사용하였다. 골반 및 요추 엑스선검사에서의 환자가 받는 입사표면선량을 측정한 결과, 골반 전후면 엑스선검사에서는 최소값 0.59mGy, 최대값 12.69mGy, 평균값 2.88mGy이었으며, 제1사분위값은 1.91mGy, 중앙값은 2.67mGy, 제3사분위값은 3.42mGy이었다. 요추 전후면 엑스선검사에서는 최소값 0.64mGy, 최대값 23.84mGy, 평균값 3.68mGy이었으며, 제1사분위값은 2.41mGy, 중앙값은 3.40mGy, 제3사분위값은 4.08mGy이었다. 요추 측면 엑스선검사에서는 최소값 1.90mGy, 최대값 45.42mGy, 평균값 10.08mGy이었으며, 제1사분위값은 6.03mGy, 중앙값은 9.09mGy, 제3사분위값은 12.65mGy이었다. 결 론 : 우리나라 의료기관에서 골반 전후면 엑스선검사에서 의료기관에 권고할 환자선량 권고량은 3.42mGy, 요추 전후면 엑스선검사에서는 4.08mGy, 요추 측면촬영에서는 12.65mGy로 세계보건기구 등 6개 국제기구가 공동으로 권고할 골반 전후면 10mGy, 요추 전후면 검사 10mGy 및 요추 측면 검사 30mGy보다는 낮았다.

Purpose : pelvis and lumbar spine radiography, among various types of diagnostic radiography, include gonads of the human body and give patients high radiation dose. Nevertheless, diagnostic reference levels for patient radiation dose in pelvis and lumbar spine radiography has not yet been established in Korea. Therefore, the radiation dose that patients receive from pelvis and lumbar radiography is measured and the diagnostic reference level on patient radiation dose for the optimization of radiation protection of patients in pelvis and lumbar spine radiography was established. Methods : The conditions and diagnostic imaging information acquired during the time of the postero-anterior view of the pelvis and the postero-anterior and lateral view of the lumbar spine at 125 medical institutions throughout Korea are collected for analysis and the entrance surface dose received by patients is measured using a glass dosimeter. The diagnostic reference levels for patient radiation dose in pelvis and lumbar spine radiography to be recommended to the medical institutes is arranged by establishing the dose from the patient radiation dose that corresponds to the 3rd quartile values as the appropriate diagnostic reference level for patient radiation dose. Results : According to the results of the assessment of diagnostic imaging information acquired from pelvis and lumbar spine radiography and the measurement of patient entrance surface dose taken at the 125medical institutes throughout Korea, the tube voltage ranged between 60~97kVp, with the average use being 75kVp, and the tube current ranged between 8~123mAs, with the average use being 30mAs. In the posteroanterior and lateral views of lumbar spine radiography, the tube voltage of each view ranged between 65~100kVp (average use: 78kVp) and 70~109kVp (average use: 87kVp), respectively, and the tube current of each view ranged between 10~100mAs(average use: 35mAs) and between 8.9~300mAs(average use: 64mAs), respectively. The measurements of entrance surface dose that patients receive during the pelvis and lumbar spine radiography sho the following results: in the posteroanterior view of pelvis radiography, the minimum value is 0.59mGy, the maximum value being 12.69mGy and the average value is 2.88mGy with the 1st quartile value being 1.91mGy, the median being 0.59mGy, and the 3rd quartile value being 3.43mGy. Also, in the posteroanterior view of lumbar spine radiography, the minimum value is 0.64mGy, the maximum value is 23.84mGy, and the average value is 3.68mGy with the 1st quartile value being 2.41mGy, the median being 3.40mGy, and the 3rd quartile value being 4.08mGy. In the lateral view of lumbar spine radiography, the minimum value is 1.90mGy, the maximum value is 45.42mGy, and the average value is 10.08mGy with the 1st quartile value being 6.03mGy, the median being 9.09mGy and the 3rd quartile value being 12.65mGy. Conclusion : The diagnostic reference level for patient radiation dose to be recommended to the medical institutes in Korea is 3.42mGy for the posteroanterior view of pelvis radiography, 4.08mGy for the posteroanterior view of lumbar spine radiography, and 12.65mGy for the lateral view of lumbar spine radiography. Such values are all lower than the values recommended by 6 international organizations including World Health Organization, where the recommended values are 10mGy for the posteroanterior view of pelvis radiography, 10mGy for the posteroanterior view of lumbar spine radiography and 30mGy for the lateral view of lumbar spine radiography.