螺旋CT在矽肺诊断中的应用价值

Clinical values of Spiral CT in diagnosis of silicosis

目的探讨螺旋CT与常规数字X线摄影检出矽肺病灶的差异。方法随机选择2004-2009年通过螺旋CT和常规数字X线摄影检查确诊的矽肺患者60例,回顾性分析两者的病灶检出率及影像学表现,用SPSS10.0统计软件对检查结果进行相关的统计学分析。结果螺旋CT检查与常规数字X线摄影检出结果分别为：0.2-1.0 cm散在中、高密度结节34、25例;大于1.0 cm的结节20、16例;大小病变同时存在6、4例;肺气肿征象52、35例;胸膜病变49、39例;伴有新或陈旧结核灶19、15例;肺门、纵隔淋巴结肿大或钙化45、25例。两者在对0.1-0.5 cm散在病灶发现率、肺气肿的评判、伴发结核病灶、淋巴结肿大或钙化等方面比较差异有统计学意义（P〈0.001）;对大于1.0 cm病灶两者比较,差异也有统计学意义（P〈0.05）。结论螺旋CT扫描有利于矽肺的正确诊断和鉴别诊断,尤其有利于矽肺微小病灶的确定,在判定肺气肿、淋巴结肿大等方面明显优于常规X线检查。

Objective To explore the imaging differences of detection silicosis lesions with spiral CT and digital X-ray photography.Methods 60 cases silicosis confirmed diagnosed through spiral CT and digital X-ray photography were randomly selected in recent 5 years,focus of infection rate and imaging detection were retrospectively analyzed by SPSS10.0 software for statistical analysis.Results The results of Spiral CT examination and digital X-ray photography detection respectively were ：34,25 cases were 0.2-1.0 cm scattered in middled and high-density nodules,20,16 cases were more than 1.0 cm of nodules,6,4 cases existed simultaneously lesions,52,35 cases signed emphysema,49,39 cases had Pleural lesions,19,15 cases with the new or old tuberculosis lesions,45,25 cases with hilar lymph node and mediastinal lymph nodes enlargement or calcification.There were statistically significant to 0.1-0.5 cm found in lesions of evaluation,emphysema,tuberculosis lesions,lymph nodes or calcified lesions（P〈0.001）,there were statistical significance in lesions more than 1.0 cm（P〈0.05）.Conclusion Spiral CT scan is good in diagnosis and differential diagnosis,especially for determine the tiny lesions of silicosis,emphysema,lymphadenectasis etc clearly superior to digital X-ray examination.