陳拓榮涂柔安Jou-An Tu醫學影像暨放射科學系碩士班2026-03-269999-12-312018https://handle.ncl.edu.tw/11296/7yx4pjhttps://scholars.csmu.edu.tw/handle/123456789/7517本研究以回溯性方法，蒐集活體肝臟移植捐贈者與受贈者(各100人，共200人)，在換肝移植手術前後接受任何輻射曝露檢查(包含一般X光攝影、電腦斷層、核子醫學檢查、透視攝影)的劑量參數，時間定義為手術日前後各一年的數據。收集劑量指標的臨床參數，包括診斷檢查次數、劑量長度積(dose length product, DLP)、劑量面積乘積(dose area product, DAP)和核醫檢查藥物活度。本研究提供各項檢查貢獻的有效劑量及可降低有效劑量的策略。本實驗依據臨床的劑量參數使用：(1)蒙地卡羅軟體模擬一般X光攝影的有效劑量，(2)美國核醫學會的醫學體內劑量委員會的劑量評估程式計算有效劑量，(3) 參考文獻中電腦斷層和透視攝影的劑量轉換因數，相乘可得到換肝移植手術中不同檢查對受贈者和捐贈者造成的有效劑量。同時也分析換肝移植手術各種輻射檢查的分佈比例、頻率、與掃描劑量。在捐贈者中，一般X光攝影、電腦斷層、透視攝影檢查的檢查次數頻率比例為：60%、27%和13%；有效劑量百分比分別是2%、97%和1%。在受贈者中，X光攝影、電腦斷層、核子醫學檢查的檢查次數頻率百分比分別是88%、7%和5%；平均有效劑量比例分別是3%、78%和19%。每位捐贈者約接受5次一般X光攝影、2次電腦斷層和1次透視攝影檢查，平均有效劑量為77毫西弗/人；每位受贈者大概會接受38次一般X光攝影、3次電腦斷層和2次核子醫學檢查，平均有效劑量為148毫西弗/人。捐贈者或受贈者術前和術後兩個月，是檢查次數的高峰期。This study collected the dose parameters of 100 donors and 100 recipients for different radiation examinations undergoing liver transplant operation with retrospective method to access the data from the hospital database. The collecting time defined as 1 year before and after living liver transplant process. The radiation modalities included radiography, CT, nuclear medicine and fluoroscopy. Also, dose indices and other clinical parameters were recorded, including the numbers of diagnostic examinations, dose length product (DLP) in computer tomography (CT), dose area product (DAP) in fluoroscopy and isotope’s activity in nuclear medicine. The study provides the contribution of effective dose attributed to different exposures and presents possible strategy to reduce dose.The effective doses were calculated based on clinical dose parameters in three methods: (1)the program of Monte Carlo simulation, (2)nuclear medicine radiation dose tool developed by MIRD, (3)the factors of DLP, DAP converted to the effective dose for donor and recipient from different radiation examinations undergoing liver transplant operation. In addition, the frequency of procedures and the average effective dose per procedure were estimated. The frequency of examinations among 100 donors for radiography, CT, and fluoroscopy were 60%, 27%, and 13%, respectively. The average effective dose percentages for radiography, CT, and fluoroscopy were 2%, 97%, and 1%, respectively. The average dose effective dose per donor was 77 mSv. Each donor was undergoing for radiography, CT, and fluoroscopy were 5 times, 2 times, and 1 time, respectively. The frequency of examinations among 100 recipients for radiography, CT, and nuclear medicine were 88%, 7%, and 5%, respectively. The average effective dose percentages for radiography, CT, and nuclear medicine were 3%, 77%, and 19%, respectively. The average dose effective dose per donor was 148 mSv. Each donor was undergoing for radiography, CT, and nuclear medicine were 38 times, 3 times, and 2 times, respectively. Two months before and after surgery, it is the most frequent period of examination. Both the donor or the recipient show the same result.有效劑量移植肝輻射effective dosetransplantliverradiationthesis