尘肺病胸部 CT 与 DR 胸片影像差异研究

doi:10.13329/j.cnki.zyyjk.20201028.001

职业与健康 ›› 2021, Vol. 37 ›› Issue (1): 5-10.DOI: 10.13329/j.cnki.zyyjk.20201028.001

尘肺病胸部 CT 与 DR 胸片影像差异研究

1. 淄博市职业病防治院放射科，山东淄博 255000；2. 山东省职业卫生与职业病防治研究院职业病科，山东济南 250062；3. 中国疾病预防控制中心职业卫生与中毒控制所，北京 100050

收稿日期:2020-07-14 接受日期:2020-09-21 出版日期:2021-01-01 发布日期:2021-03-03
通讯作者: 王焕强，研究员，E-mail：wanghq@niohp.chinacdc.cn
作者简介:王成霞，女，副主任医师，主要从事职业病临床工作
基金资助:
中国卫生监督协会团体标准项目（2019-44）

Study on difference of chest CT and DR chest radiography in pneumoconiosis

1.Department of Radiology， Zibo Occupational Disease Prevention and Control Hospital， Zibo Shandong， 255000， Chinａ；２.Occupational Disease Department， Shandong Institute of Occupational Health and Occupational Diseases Prevention， Jinan

Shandong， 250062， Chinａ； 3.Institute of Occupational Health and Poisoning Control, Chinese Center for Disease Control and Prevention， Beijing， 100050， China

Received:2020-07-14 Accepted:2020-09-21 Online:2021-01-01 Published:2021-03-03

摘要/Abstract

摘要：

目的分析尘肺病胸部电子计算机断层扫描（CT）图像的特点，以及与数字化 X 线摄影（DR）胸部正位片影像表现的差异，了解 CT 用于尘肺病诊断与分期的成像方法与价值。方法对 2018 年 11 月 22 日—2019 年 6 月 26 日期间淄博市职业病防治院诊断的 113 例尘肺病患者做 DR 胸部正位片和高分辨率 CT 扫描，用 2、5 mm 层厚分别成像，对 DR 胸片和 CT图像尘肺小阴影、大阴影、肺气肿、淋巴结和胸膜增厚等影像学表现的差异进行对比分析。结果尘肺 DR 胸片的小阴影在CT 图像表现为结节和弥漫纤维化 2 种改变，结节型改变 107 例（94.69%），表现为环形和实性结节。 CT 和 DR 对尘肺小阴影形态和大小、纵膈淋巴结增大、肺气肿及胸膜增厚等征象的显示差异有统计学意义（P<0.01），两种检查方法的一致性较差（Kappa<0.4）。结论尘肺病胸部 CT 和 DR 影像学表现差异显著，CT 能更准确地反映尘肺病的形态学改变，用于尘肺病的诊断和分期能更准确地反映患者的病情。

关键词:

尘肺病, 电子计算机断层扫描, 胸部, 数字化 X 线摄影

Abstract:

Objective To analyze the characteristics of chest computed tomography（CT） images of pneumoconiosis and the differences between CT and digital radiography（DR） chest radiographs，explore the imaging method and value of CT in the diagnosis and staging of pneumoconiosis. Methods Totally 113 patients with pneumoconiosis， who were diagnosed in the Zibo Occupational Disease Prevention and Control Hospital from November 22， 2018 to June 26， 2019， were given DR chest radiographs and high-resolution CT scans， and CT scan used 2 and 5 mm layer thickness to image respectively. The differences in imaging manifestations of small shadows， large shadows， emphysema， lymphnodes， and pleural thickening of pneumoconiosis between DR chest radiograph and CT images were compared and analyzed. Results The small shadow of pneumoconiosis DR chest film showed nodular and diffuse fibrosis changing on CT images. Nodular changes were found in 107 cases（94.69%）， showing circular and solid nodules. There were statistically significant differences between CT and DR in showing the shape and size of small shadow， mediastinal lymph node enlargement， emphysema and pleural thickening in pneumoconiosis （P<0.01）. The consistency of the two methods was poor（Kappa<0.4）. Conclusion There is a significant difference in chest CT and DR imaging findings of pneumoconiosis. CT can more accurately reflect the morphological changes of pneumoconiosis， and can more accurately reflect the condition of patients in the diagnosis and staging of pneumoconiosis.

Key words:

Pneumoconiosis, Computed tomography, Chest, Digital radiography

王成霞, 王宁宁, 仇路, 蔡志春, 崔萍, 王焕强.

尘肺病胸部 CT 与 DR 胸片影像差异研究

[J]. 职业与健康, 2021, 37(1): 5-10.

WANG Cheng-xia, WANG Ning-ning, QIU Lu, CAI Zhi-chun, CUI Ping, WANG Huan-qiang.

Study on difference of chest CT and DR chest radiography in pneumoconiosis

[J]. OCCUPATION AND HEALTH, 2021, 37(1): 5-10.

尘肺病胸部 CT 与 DR 胸片影像差异研究

Study on difference of chest CT and DR chest radiography in pneumoconiosis

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