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  • 28 August 2021 Volume 30 Issue 4
      

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  • RAN Xinze, YUAN Yang, WANG Junping
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  • ZHANG Manyu, LIU Ning, CHEN Huipeng, YE Xiaohua, YAO Zhenjiang, ZHONG Xinguang
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    Objectives To explore the dose-response relationship between low-dose ionizing radiation and thyroid hormone levels of radiation medical workers and provide theoretical basis for occupational health protection to this population.Methods Using a prospective cohort study design, we collected health examination reports on employees that worked on jobs with occupational exposure to radiation at hospital with individually dose monitoring data for 1 237 workers. The effective cumulative radiation dose was divided into three groups: 0~2.586 mSv, 2.586~3.757 mSv, 3.758~31.272 mSv by the interquartile range. The low-dose group was used as a reference to compare the changes in thyroid hormones of medical workers in different cumulative radiation dose groups. The generalized linear models and restricted cubic spline model were used to examine the association and dose-response relationship between the cumulative effective dose and changing thyroid hormones.Results There were statistically significant differences in changing thyroxine (T4) and Free triiodothyronine (FT3) levels among three different dose groups of 1237 subjects (P < 0.05). The results of generalized linear models analysis revealed that 2.586~3.757 mSv was a significant risk factors of changing T4, with β of 3.514 (95% confidence interval [95% CI]: 0.900~6.128) after adjusting for gender, age, working duration, occupation, medical level and smoking, while the association with changing FT3 was not observed (P > 0.05). The restrictive cubic spline (RCS) model analysis indicated a non-linear dose-response correlation between cumulative radiation dose with changing T4 (P = 0.023).Conclusion Long-term exposure to low-dose ionizing radiation could induce the thyroid damage among medical occupational population. And there is a dose-response relationship between cumulative radiation dose and changing thyroxine.
  • SHAN Tiemei, FU Lili, WANG Lidong, LI Yeming, DUAN Xiaoxiao, TIAN Xinxin, NA Xiangjie
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    Objective To analyze peripheral blood hemogram, lymphocyte micronucleus and chromosomal aberrations of radiologists, so as to provide basis for occupational protection and health monitoring of radiologists.Methods Lymphocyte micronucleus, chromosome and blood hemogram analysis were performed on 127 radiologists who received health examinations in 2015, 2017 and 2019, and they were assigned to the radiation group. In addition, 133 medical staff with no history of radiation exposure were selected as the control group.Results The micronucleus rate and chromosome aberration rate of the radiation group were higher than those of the control group, and the white blood cell and platelet counts were lower than those of the control group, both of which were statistically significant (P < 0.05). The total number of white blood cells in peripheral blood of 127 radiologists decreased gradually with the increase of exposure time to ionizing radiation, and the chromosome aberration rate increased gradually, all of which had statistical significance (P < 0.05). The rate of chromosomal aberration was higher in radiologists with damage work age of more than 20 years than in the low-work age group, and there was no statistical significance between different damage work age (P > 0.05). The chromosome aberration rate of nuclear medicine and interventional therapy was higher than that of other types, with statistical significance (P < 0.05).Conclusion Long-term exposure to low-dose ionizing radiation can reduce the total number of white blood cells and increase the chromosome aberration rate of radiologists. It is necessary to strengthen the protective measures for radiologists to reduce the degree of ionizing radiation damage, especially to strengthen the occupational protection for radiologists in nuclear medicine and interventional therapy.
  • DONG Ying, WU Yingyu, TANG Mengjian, QIN Zhiying, XIE Ping, CHEN Faxiang, CHEN Zhangfan
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    Objective To understand the level of quality control in medical linear accelerator in Guangxi, and to provide technical support for the health administrative department to make related standards.Methods To select medical linear accelerators in Guangxi by random sampling method.Results A total of 118 accelerators were checked in 2017—2019, the initial inspection pass rates of medical linear accelerators were 56.8% and re-inspect pass rate were 96.6%.Conclusion The quality control level of the radiology institutions needs to be improved. The health administrative department should strengthen routine management,it is necessary to implement quality control in medical linear accelerator.
  • ZHAI Shuguang, FENG Zechen, YU Jun, ZHU Weijie, HAN Jun, SONG Lin, ZHANG Zhibin, BAI Bin
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    Objective To analyze the distribution status and agglomeration degree of radiological diagnosis and treatment resources in Beijing, and provide references for rationally coordinating the allocation of radiological diagnosis and treatment resources, formulating resource allocation policies, and promoting the stable development and efficient use of radiological diagnosis and treatment resources.Methods Based on the medical radiation protection monitoring data of Beijing medical and health institutions from 2019 to 2020, the current situation of radiological diagnosis and treatment resources is described by the number of radiological diagnosis and treatment resources, the average service volume, and the resource composition, and the distribution of radiological diagnosis and treatment resources in Beijing is evaluated with the aid of the agglomeration degree.Results The number of radiological diagnostic equipment, the number of service personnel, and the number of radiological workers engaged in third-level hospitals is the largest; for the number of service personnel for each type of single equipment, third-level hospitals account for a larger proportion, and radiotherapy and nuclear medicine services are concentrated in third-level hospitals. Human resource pressure and equipment service pressure are relatively high in third-level hospitals. First-level hospitals mainly undertake radiological diagnosis services. There is little difference in the amount of radiological diagnosis services per capita between second-level hospitals and third-level hospitals. Nuclear medicine and radiotherapy in third-level hospitals per capita service volume is significantly higher than that insecond-level hospitals. Radiological diagnosis and radiotherapy resources are concentrated in urban areas to a large extent.Conclusion There are obvious differences in the utilization of radiological diagnosis and treatment resources in different levels of hospitals. There is a significant concentration of radiological diagnosis and treatment resources in various districts. There is a certain degree of unbalanced distribution and inadequate utilization of radiological diagnosis and treatment resources in Beijing.
  • HE Lijuan, ZHANG Ling, HE Tinggui, YIN Chunxu, Hu Xi, Liang Baohui
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    Objective Based on the anthropomorphic phantom experiment and Monte Carlo simulation, the patients’ skin dose, professionals’ dose, and spatial distribution of DSA (Digital Subtraction Angiography) radiation field in an intervention procedure, was performed, in order to provide the basis for the inference of patients’ skin injury and professionals’ radiation protection in intervention procedure.Methods In the simulation experiment, a PBU-60 anthropomorphic phantom was used as the patient and the skin dose of patient’s abdomen was measured by TLD (Thermoluminescence Dosimeters). X-ray and gamma radiation dosimeter (AT1121) was applied to measure the spatial distribution of DSA radiation field, which was verified using Monte Carlo software MCNP meanwhile. Furthermore, the radiation dosimetry of operative staffs at different stations and under different protection conditions was studied experimentally.Results The experimental measurements showed that the maximum skin dose of patients every 5-minute fluoroscopy was 18.62 mGy under the irradiation of PA in an abdominal interventional procedure. The results of Monte Carlo simulation and measurement experiments showed that the spatial distribution of DSA radiation fieldis similar to the butterfly distribution, which is related to distance and angle. The experimental results showed that the dose rate decreases exponentially with the increase of lead equivalent.Conclusion It is very significant to carry out skin dose measurementof patients during interventional surgery and follow-up patients with high dose after surgery. In interventional surgery, doctors should try to avoid the station of high dose rate. However, it is necessary to strengthen the radiation protection of the operator and the first assistant. Under the dual protections of bedside lead protective equipment and personal protective equipment, the exposure dose of intervention personnel can be significantly reduced.
  • ZHENG Haiying, CHEN Wei, DENG Dongzheng, LI Yunhui, ZHOU Yuchao
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    Object the current radiological health situation of different ranks medical institutions of interventional radiology in a city of Pearl Delta.Methods all the medical institutions in the city, which had carried out interventional radiology before December 31, 2019 as the research objects by survey. By using the method of field epidemiological investigation, the basic situation of general messages, the status of protective facilities, environmental radiation does, personal protective equipment, occupational health monitoring were investigated.Results There were 12 interventional radiology equipment and 180 employees in 7 medical institutions in the city, before December 31, 2019. There was no statistical significance in the composition of employees of different ranks medical institutions (P > 0.05). There was no statistical significance in the composition of protective facilities for interventional treatment in different ranks hospitals (P > 0.05). The environmental radiation dose in interventional radiology devices room of grade A class 3 hospital was higher than that of grade A class 2 hospital (P < 0.05). There was no statistical significance in the composition of individual protective equipment for interventional therapy in different ranks medical institutions (P > 0.05). The proportion of occupational health examination before work and during work in grade A class 2 hospital was higher than A class 3 hospital (P < 0.01).Conclusion The current situation of radiological health of different ranks medical institutions of interventional radiology in a city of Pearl Delta was good momentum. It may be helpful to improve the radiological health protection level of interventional therapy in this city by strengthening the radiological protection management of applying for interventional therapy, actively carrying out the evaluation of radiological protection against occupational disease hazards in construction projects, and urging the employee to carry out the occupational health monitoring inspection as required.
  • ZHENG Qishan, ZHANG Yan, ZHENG Senxing, HUANG Lihua, LIU Jia, FENG Yajuan, WANG Denan
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    Objective To investigation the radioactivity level of 90Sr in tea leaves within and outside 30 km range of Ningde nuclear power plant.Methods The tea leaves within and outside the 30 km range of Ningde Nuclear Power Plant were collected from 2013 to 2018. According to“Radiochemical analysis of strontium-90 in water and ash of biological samples” (HJ 815—2016), the separation and analysis of 90Sr-90Y were carried outusing the method of di (2-ethylhexyl) phosphate (HDEHP) chromatography.Results During the period of 2013-2018, the radioactivity concentrations of 90Sr in the tea leaves within the range of 30 km around the Ningde nuclear power plant were 0.486~13.29 Bq/kg and that of 90Sr in the tea leaves outside the range of 30 km around the nuclear power station were 1.021~17.19 Bq/kg.Conclusion During the six years of operation in Ningde Nuclear Power Plant, there was no increase in the radioactivity level of 90Sr in the tea leaves around the nuclear power plant.
  • TIAN Kun, XIA Bing, Wang Hui
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    Objective To carry out the gross alpha and gross beta radioactivity monitoring in Lixiating surface water in Daming Lake from 2014 to 2019, so as to understand the current situation of radioactive environmental quality of surface water in Daming Lake.Methods The water samples were collected at Lixiating site during the wet water (March to June) and dry water (September to December). After the pre-treatment process of evaporation, carbonization and ashing, the samples were measured by the ultra low background level α and β counter.Results During 2014 to 2019, the gross alpha activity in the surface water of Lixiating water in Daming Lake was 0.030-0.066 Bq/L, with an average of 0.048 Bq/L, and the gross beta activity was 0.085-0.126 Bq/L, with an average of 0.102 Bq/L.Conclusion The surface water of Lixiating in Daming Lake water was not contaminated by radionuclide and it was safe for public health.
  • LI Man, WANG Kai, WANG Zhen
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    Objective To understand the influence of a pharmaceutical industrial park in North China on the gross α / β radioactivity levels in the surrounding environment.Methods Environmental samples in the surrounding area of the Pharmaceutical Industry Park in 2019, including aerosols, sedimentation ash, well water and biological samples, etc., were collected and treated according to standard methods. FYFS~400X low background α and β radioactivity detector was used to detect the gross α/β radioactivity level.Results In 2019, the gross α/β radioactivity levels in aerosols in a single month were 795~978 μBq/m3 and 1111~1304 μBq/m3, respectively, and in the sedimentation ash were 29~34 Bq/m2 and 36~49 Bq/m2, respectively. They were 0.120~0.235 Bq/L and 0.126~0.343 Bq/L in well water, 0.077~0.149 Bq/kg and 100.2~219.4 Bq/kg in the vegetable, 0.171~0.581 Bq/kg and 154~296 Bq /kg in the chicken, 0.147~0.376 Bq/kg and 97~190 Bq/kg in pork, respectively.Conclusion The monthly gross α/β radioactivity levels in the surrounding environment of the pharmaceutical industrial park has seasonal variation in aerosol and sedimentation ash, but no significant change in well water and biological samples, which requires continuous dynamic monitoring
  • WANG Chunhong, WU Zhao, LIU Senlin, MIAO Xiaoxiang, SUN Quanfu
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    Objective Collect and analyze data of radiation level of 210Po/210Pb in cigarettes in China, evaluate the internal radiation dose caused by smoking to Chinese smokers and compare it with other countries.Methods The radiation levels of 210Po/210Pb in cigarettes in domestic and foreign countries were summarized and analyzed, and the fractions of 210Po/210Pb in mainstream smoke were recommended, and the internal radiation doses to smokers in China were estimated.Results In 2015, there were 320 million smokers among aged 15 and above in China with an average smoking amount of 15.2 cigarettes per day. The average activities of 210Po/210Pb weighted by the number of cigarette brands were 28.2 mBq per cigarette and 39.3 mBq per cigarette respectively. The mainstream smoke fraction of 20% of 210Po was used to make the does estimation which was the mean value of the experimental results of simulator and volunteers, and that of 210Pb was 10% measured by simulators. Based on the average smoking amount per day and the number of smokers in China, the annual effective dose of current smokers in China is 126 μSv·a-1, and the collective effective dose is 40746 man·Sv.Conclusion The content of 210Po/210Pb in Chinese cigarettes is about 2~3 times that of other country's cigarettes. However, the fraction of mainstream smoke and dose conversion coefficient of 210Po/210Pb adopted in this paper are different from those in other literatures. Therefore, the estimated dose of 20 cigarettes for Chinese smokers is lower than that for smokers in some countries.
  • CHEN Qun, YANG Xiaoyong, FENG Ziya, MA Jiayi, SHI Xiaodong
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    Objective To understand the background level of total radioactivity in drinking water around Tianwan Nuclear Power Plant.Methods According to the original plan of the National Health and Family Planning Commission of China, the monitoring of gross α and gross β radioactivity levels in drinking water during dry and rain periods around Tianwan Nuclear Power Plant, and water samples were collected including source water, factory water, peripheral water and reservoir water.Results A gross of 200 water samples were monitored at 35 sampling sites from 2016 to 2018.The gross α and gross β radioactivity levels in the dry period were (0.038 ±0.033) Bq/L and (0.11 ±0.03) Bq/L. The gross α and gross β radioactivity levels in the wet period were (0.038 ±0.024) Bq/L and (0.11 ±0.03) Bq/L. There were statistically significant differences in gross α and gross β radioactivity levels between the source water and the other water during the dry season (P < 0.05). There were statistically significant differences in gross α and gross β radioactivity levels in different years (P < 0.05). There were statistically significant differences in gross α and gross β radioactivity levels at different distances from the nuclear power plant (P < 0.05).Conclusion The gross α level and gross β level of radioactivity in drinking water around Tianwan Nuclear Power Plant are in line with the standard of drinking water, regular, fixed and continuous monitoring should be carried out, and radionuclide monitoring and radiological investigation should be carried out on this basis.In view of the density of personnel in the vicinity of nuclear power plants in China, nuclear emergency preparedness training should also be strengthened.
  • GUAN Lei, YANG Fei
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    Objective To analyze the abnormal results of individual dose monitoring of some radiation workers in Chengdu from 2016 to 2018, so as to take corresponding measures to avoid similar abnormal situations.Methods The individual dose was monitored by thermoluminescence method, and the monitoring results were analyzed by spss19.0 statistical software.Results From 2016 to 2018, the number of people with abnormal dose was basically the same, and there was no significant difference in the number of people with abnormal dose in different years (P > 0.05); the number of people engaged in diagnostic radiology with abnormal personal dose accounted for 75.96%; the first reason for the abnormal personal dose was that "the personal dosimeter had been left in the radiation workplace", accounting for 92.55%.Conclusion The main reason for the abnormal results is that the dosimeter is not worn properly, so the management should be further strengthened.
  • YANG Li, WANG Lijiao, SHAO Minggang, KONG Fanfan, WANG Zhongwen
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    Objective To discuss the quality control measures of the thermoluminescent dosimetry system and to verify its propriety of when used in environmental radiation monitoring.Methods The quality control measures included the stability test, the dispersibility screening and the uncertainty evaluation of measurement results of the TLD reader and TLD detector, in addition, the environmental radiation accumulated dose monitoring results obtained by the high pressure ionization chamber were compared with those by the thermoluminescent dosimetry system.Results The variation range of TLD reader’s light source coefficient is within 0.070 ~ 0.073 during the preheating and measuring process, which meets the requirements of stability; The χ2 value of the TLD detector is 2.088, which obeys the normal distribution; The thermoluminescent dosimetry system’s nonlinear response, coefficient of variation and energy response meet the measurement requirements; There is a deviation of -6.58% the largest between the cumulative dose obtained by TLD and the high pressure ionization chamber.Conclusion The quality control measures discussed in this paper can be used as a reference for similar thermoluminescent dosimetry system. Our system has passed all the tests and can meet the environmental radiation cumulative dose monitoring requirements.
  • FU Yaping, SONG Yiqian, SUN Peng, CHEN Ling
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    Objective This study intends to analyze the radioactivity level of slag and its building materials, estimate the effective dose of the residents caused by the comprehensive utilization of slag in building materials, and provide basis for rational utilization of slag.Methods Data of slag production and its comprehensive utilization in building materials, radioactive level investigation and detection of slag and building materials in different periods and regions were collected from 2005 to 2016. Using the room model of concrete structure and the model of calculating equilibrium equivalent radon concentration with the specific activity of 226Ra in indoor building materials, the external and internal radiation doses of residents caused by comprehensive utilization of slag for building materials were estimated respectively, and then the annual additional effective dose and collective dose of residents were estimated.Results The contents of 226Ra and 232Th in the slag were relatively high, while the contents of 40K were relatively low. The radionuclide content in slag cement decreased significantly. The annual additional effective doses of slag used in concrete and cement mixture relative to ordinary cement were 0.40 mSv·a−1 and 0.20 mSv·a−1 respectively. The annual additional collective dose and 50-year collective dose caused by slag used in building materials were 3.87×103~1.84×104 man·Sv and 1.94×105~9.20×105 man·Sv respectively.Conclusion The comprehensive utilization of slag in building materials increases the additional effective dose of residents, so the use of some slag in building materials needs to be paid more attention to. In addition, the influence of comprehensive utilization of slag in building materials, such as the way, the amount of slag and the amount of building materials, on the annual additional effective dose of residents caused should also be paid attention to.
  • SUN Zhongtao, JIANG Yishan, ZHANG Dong, ZHAO Xin
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    Objective Radiation safety of emergency repair personnel in the reactor cabin under the natural circulation condition of the reactor is studied, the radiation protection method of emergency repair personnel in the reactor cabin is described, which provides a theoretical reference for personnel radiation protection and emergency repair time control.Methods The radiation was simulated by the Monte Carlo method for emergency repair personnel in the reactor cabin under the natural circulation condition of the reactor, and the radiation was also analyzed with the radiation data measured by experiments in the reactor cabin under the natural circulation condition of the reactor.Results The neutron dose of external irradiation about reactor simulated computation was 140 μSv/h, and gamma radiation dose rate was 48 μSv/h. By experiment and calculation, the effective dose received by emergency repair personnel in the 30-minutein the reactor cabin was 2.2 mSv.Conclusions Under the natural circulation condition of the reactor, the gamma radiation is harmful to emergency repair personnel, but the focus of protection is different locations for maintenance. It's safe for emergency personnel to repair the reactor in 30 minutes in turn, wearing the respirators.
  • LIU Liying, ZHU Ruokai, ZHOU Ning, WANG Zhe, CHEN Yishui, LIU Yongquan
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    Objective To investigate the reasons why the routine monitoring of personal dose of occupational external exposure of some radiological workers in our province reached the investigation level in 2018, so as to provide technical support for the correct decision making of administrative departments.Methods The registration forms for monitoring and verifying the personal dose of occupational external exposure were issued to radiation workers whose periodic dose reached or exceeded 1.25 mSv/ cycle.Results A total of 102 person-times were sent out in 53 verification forms, and 95 person-times were collected in 47 copies. The recovery rate was 88.68%, and 7 person-times did not feedback the verification forms. There were 15 cases of actual exposure, accounting for 15.79%, including 5 cases of radiological diagnostic staff, who did not close the protective door when operating exposure. Among them, the other 80 cases, accouting for 84.21% didn't receive actual exposure.Conclusion The vast majority of radiological workers who reached the survey level didn't receive actual exposure. 5 person-time radiological diagnostic staff, during the work did not close the protective door, subjected to abnormal radiation. Interventional medicine, nuclear medicine and industrial mobile flaw detection workers are at higher risk of abnormal exposures during their work. The suspicious results of the questionnaires without feedback were all less than the annual dose limit and the requirements of audit management. We will strengthen supervision of radiation health protection, raise the awareness of radiation protection among radiation workers, and improve radiation protection management and protection conditions for radiation workers in interventional medicine, nuclear medicine and industrial mobile flaw detection furtherly.
  • WANG Shuo, TUO Fei
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    Since the Chernobyl nuclear accident, the radioactive contamination in food caused by the nuclear accident has been widely concerned by people. There have been a lot of studies on concentrated radionuclides in mushrooms in foreign countries, but the research on radionuclides content and transfer distribution mechanism of radionuclides in mushrooms is almost blank in China. Studies have shown that mushrooms have a strong adsorption capacity on radionuclides. As a common food in daily life, therefore, it is of great significance to study the content of radionuclides in mushrooms for evaluating the internal dose in the human body. In this paper, the types of radionuclides in mushrooms and the methods of their transfer and distribution in mushrooms were reviewed, and the research status and development trends at domestic and abroad in recent years were emphasized, in order to provide theoretical support for the future basic research.
  • MA Guoxue, SONG Zhiyan, ZHAO Guangcui, ZENG Liping, GAO Peng, HUANG Wei
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    Transport monitoring is an important link in the transport process of radioactive materials, involving the whole process, that is, before departure, during transportation and after arrival. To do well in transport monitoring, radiation monitoring organizations need to actively participate in the work, and also need to do a good job in the supervision of radioactive materials transport monitoring. Beijing is one of the radioactive materials distribution centers in China, the monitoring workload is large, the number of monitoring reports is large, the number of packages by air transportation is relatively large, and the transportation and monitoring for medical use is dominant. Through the introduction of radioactive materials transportation monitoring work, and analysis of 2006—2020 radioactive materials transportation monitoring situation, this paper discusses the problems that need to be paid attention to in the monitoring work and the ways to deal with them, so as to provide ideas for radiation monitoring organizations to carry out monitoring work and manage the transport of radioactive materials well.
  • WANG Jinping, LIU Shuai, LIN Weifeng, HUI Taotao
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    Objective The combined application of X-ray photography and various ultrasound examination techniques to evaluate the clinical outcome of developmental dysplasia of the hip (DDH) in early diagnosis and treatment.Methods A retrospective analysis of the data of 296 hips in 148 infants with DDH risk factors from September 2017 to September 2018 was classified by Graf method. Harcke method was applied to evaluate the stabilities of the hips. Ottobock harnesses was used for treatment depending on the classification. Human position spica cast would be given if no efficacy was seen and Novick method was applied to observe the location of femoral head and acetabulum. X-rays were given to the infants underwent treatments when they were above 1 year old and the developments of the hips were evaluated.Results There were 207 type Ⅰ hips, 76 type Ⅱ hips, 3 type D hips, 6 type Ⅲ hips and 4 type Ⅳ hips as Graf classification at first examination. 248 hips were stable, 27 hips were relaxed, 5 hips were dislocated when compressed, 13 hips were reducible and 3 hips were irreducible as Harcke classification. 81 hips were treated in all. All the hips turned to be in normal range at age of 1 year.Conclusion The combination of X-ray scan and three ultrasound tools are effective to comprehensively assess the hip joint and precisely diagnose DDH, which may benefit more infants.
  • CHEN Yunzhi, LI Wenwu
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    Objective To investigate the predictive value of MSCT imaging features on the pathological risk of gastrointestinal stromal tumors (GISTs).Methods The MSCT manifestations of 120 GISTs patients confirmed by operation, pathology and immunohistochemistry were analyzed retrospectively. The age of tumor onset, location, maximum diameter, morphology, growth pattern, cystic necrosis, calcification, peritumoralfat space, enhancement pattern, peritumoralor intratumoral vessels, peak period of enhancement, metastasis, and the relationship between Ki-67 proliferation index and pathological risk grade were also analyzed.Results Among 120 cases, there were 55 cases of extremely low and low risk, 28 cases of moderate risk, and 37 cases of high risk. There were significant differences in location, tumor diameter, morphology, growth pattern, cystic necrosis, peritumoral fat space, enhancement pattern, peritumoral or intratumoral vessels, peak period of enhancement, and Ki-67 proliferation index of GISTs (P < 0.05). There was no significant difference in calcification, CT plain scan, enhanced scan (3 phase), peak value and Ap、Vp、Dp of GISTs with different risk (P > 0.05).Conclusion There are differences in the performance of multi-layer spiral CT (MSCT) in GISTs with different risk levels. It is closely related to the classification of pathological risk. For the diagnosis of GISTs, clinical treatment plan formulation and prognosis, it has important reference value.
  • CHI Jing, XU Dongfeng, YIN Shengnan, DING Ning, ZHAO Xuewen, JI Yiding
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    Objective To evaluate the feasibility of dual-source low-dose computed tomography (CT) of the paranasal sinus in children, with acquisition at an ultra-low tube voltage (70 kVp) combined with the Flash scan.Methods CT scans of the paranasal sinus were performed on 80 pediatric patients who were divided into two groups according to different protocols (70 kVp protocol with Flash scan mode and the iterative reconstruction, pitch 3, the experimental group (group A), n = 40; 80 kVp protocol with conventional spiral mode, pitch 1.5, control group (group B), n = 40). For each examination, the CT dose index (CTDIvol), dose-length product (DLP) and effective dose (ED) were estimated. The image noise, signal-to-noise ratio (SNR) and overall subjective diagnostic image quality were also evaluated.Results The images of these two groups were all satisfied for the clinical diagnosis. For radiation dose, the CTDIvol (mGy), DLP (mGycm) and ED (mSv) values of the 70 kVp protocol were significantly lower than those of the 80 kVp protocol [CTDIvol: 0.39 ±0.004 vs1.57 ±0.009 mGy, P < 0.001; DLP: 6.31 ±0.52 vs 19.88 ±2.01 mGycm, P < 0.001; ED: 0.024 ±0.005 vs 0.079 ±0.016 mSv, P < 0.001. Compared with those of the 80-kVp protocol, the image noise and the SNRbone increased, the SNRsoft-tissue decreased. There was no statistical difference in the subjective scores of the two groups of image quality by the two physicians (P > 0.05).Conclusion When diagnosing the paranasal sinus in children, an ultralow tube voltage (70 kVp) combined with the Flash scan technique can reduce the radiation dose significantly while maintaining diagnostic image quality with clinically acceptable image noise.
  • HE Guanghui, ZHANG Haiqing, LI Xinhua, DING Wenyu, LIU Lei, ZHANG Yong, XIONG Wen
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    Objective With the help of computerized tomography (CT) and susceptibility-weighted imaging (SWI) examinations, to analyze and compare the incidence and the prevalent sites of microbleeds (CMBs) in control group, diabetes group, hypertension group and diabetic hypertension group with intracerebral CMBs. The risk factors for the onset of CMBs also will be explored, in order to provide a basis for the selection of clinical diagnosis and treatment options for CMBs.Methods A collection of 174 non-acute patients in the Department of Neurology of Shandong Electric Power Central Hospital from May 2019 to October 2020, including 101 males and 73 females, aged 45-89 years, with an average age of 72 ±5 years. Divided into four groups according to disease types: Hypertension with type 2 diabetes group, Hypertension group, Type 2 diabetes group, Control group (no hypertension and type 2 diabetes). All patients underwent CT and MRI SWI sequence scans. The 4 groups of patients were matched in terms of gender and age, excluding the influence of gender and age. The incidence, number and distribution of CMBs in the four groups were counted, and the CT and SWI imaging manifestations of CMBs in the four groups were analyzed and compared.Results CT did not find the incidence of CMBs in the brain of patients. SWI imaging showed that CMBs were detected in 58 of 174 patients (incidence rate 33.3%), and CMBs occurred in 24 cases of diabetes and hypertension group (incidence rate 57.1%). CMBs occurred in 21 cases in the hypertension group (incidence rate 46.7%), 8 cases in the diabetes group (incidence rate 22.2%), and CMBs occurred in 5 cases in the control group (incidence rate 9.8%). The incidence of CMBs in the hypertension group and the diabetes combined with hypertension group was significantly higher than that in the control group (P < 0.05). There was no significant difference in the incidence of CMBs in patients with simple diabetes compared with the control group. Also, there was no significant difference in the incidence of CMBs between the diabetes combined with hypertension group and the simple hypertension group.Conclusion CT did not find the incidence of CMBs in the brains of patients in the non-acute phase. SWI could clearly show the CMBs of the enrolled patients. Diabetes is less likely to cause an increase in CMBs. Hypertension is significantly related to the occurrence of CMBs. CMBs associated with hypertension or/and diabetes are common in the basal ganglia and thalamus, which is different from cerebral amyloid angiopathy, which provides a basis for the choice of clinical treatment options.
  • REN Xiuhong, ZHANG Meifang
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    Objective To compare the clinical value of chest CT and Magnetic Resonance Imaging (MRI) in the diagnosis of lymph node metastasis of thoracic esophageal cancer.Methods A retrospective analysis of 90 patients with thoracic esophageal cancer lymph node metastasis diagnosed and treated in our hospital from July 2015 to June 2019. All patients underwent chest CT and MRI scans after admission, and the lesion tissue samples were taken for pathological examination after surgery. Physical examination, with pathological diagnosis results as the gold standard, analyze the sensitivity and specificity of chest CT and MRI.Results The sensitivity, specificity, positive predictive value, and negative predictive value of MRI scan was 88.73%, 94.74%, 98.44%, and 69.23%, respectively, which were higher than 69.01%, 52.63%, 84.48%, and 31.25% of the chest CT scan. In the distribution of lymph node metastasis, the middle of the thorax was the largest, and the proportions of the upper, middle, and lower thoraxes were 26.67%, 60.00%, and 13.33%, respectively. The uppermost mediastinal and paratracheal lymph nodes had the largest metastases in the upper thorax, the paratracheal and subcarinal lymph nodes in the middle thoracic segment had the most metastasis, and the next to the cardia and left gastric artery lymph nodes in the lower thorax had the largest metastases. The accuracy of MRI diagnosis is higher than that of chest CT.Conclusion Both chest CT and MRI can diagnose lymph node metastasis of thoracic esophageal cancer. The diagnostic value of MRI in diagnosing lymph node metastasis of thoracic esophageal cancer is better than chest CT. The diagnostic accuracy of MRI in each part of the lymph node is higher than that of chest CT, which can show the lymph nodes more clearly in transfer situation.
  • ZENG Zili, LIN feng, TAN yong
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    Objective To measure set-up errors in intensity modulated radiotherapy of postoperative rectal cancer (IMRTPRC), and analyze the effects of target volumes and normal tissues by set-up errors in IMRTPRC.Methods electrical field device was used to measure the set-up errors of 30 patients in IMRTPRC; we randomly selected 6 patients, and simulated their radiotherapy set-up errors in TPS. Then were counted the dose distribution and analyze relative dosimetrical parameters of target volumes, normal tissues and got the set-up errors effecting on dosimetry. Statistical analysis was performed using an SPSS statistical package(Version 19.0).Results The set-up errors on X, Y and Z direction are (-0.82 ±2.67) mm, (0.42 ±2.91) mm and (0.47 ±1.64) mm respectively. In regard to set-up errors of L5, R7, G8, T5, B6 and A4, most of statistical properties of PTV’s D98%, D95%, D50%, D2%, Hi and Ci are smaller than 0.05, so the differences have statistical values; In L5-Hi, G8-D2%, T5-D50% and B6-D2%, so these differences have not statistical value (P>0.05). In L5, R7, G8, T5, B6 and A4, about half of the statistical properties of normal tissue like bowl, bladder and femur heads, are smaller than 0.05 and have statistical value, and the rest of them are negative.Conclusion The dose of PTV is decreased due toset-up error. Uniformity and conformity is also gone bad. So the dosimetry quantity of PTV can not get reach to the initial design level. However, the dose of normal tissues like bowl, bladder and femur heads, are increased unexpectedly.
  • WANG Xinmiao, WANG Junping, RAN Xinze
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    Bleeding caused by ionizing radiation involves many factors, the mechanism is complicated and the management is difficult. Bleeding is recognized as one of the main causes of death after ionizing radiation. In this paper, we summarize the pathophysiological mechanisms of ionizing radiation bleeding syndrome (IRBS) from the aspects of platelet abnormality, coagulation disorder and vascular damage. Besides, we expound the clinical characteristics of IRBS in terms of the degree, time and site of the bleeding. Combined with experimental results, we put forward ideas and possible approaches for the treatment of IRBS, and the key factor is to promote the recovery of megakaryocytes and rapid platelet production after radiation exposure.