X线胸片与常规CT、HRCT对矽肺及其合并症诊断的对比分析

Comparative analysis between chest radiography,conventional CT and HRCT in the diagnosis of silicosis and its complications

目的比较X线胸片(CR)、常规CT(CCT)及高分辨率CT(HRCT)3种方法在矽肺诊断中的作用。方法 173例经山西省尘肺诊断组确诊为矽肺的患者均经X线胸片、常规CT以及HRCT检查,对获自3种检查方法的影像表现进行对比分析。结果本组病例可评价的影像表现包括小阴影、大阴影、小叶间隔增厚、网格及蜂窝状阴影、胸膜下弧线、各种类型肺气肿、胸膜肥厚钙化、肺门与纵隔淋巴结钙化、主肺动脉(MPA)增粗或伴结核灶。HRCT在显示小阴影、肺间质纤维化、肺气肿征象方面明显优于CT、X线胸片,而X线胸片在显示大阴影、肺间质纤维化、肺气肿、胸膜改变征象方面不及CT和HRCT。结论胸部CT尤其是HRCT在矽肺诊断方面有重要意义,与X线胸片相结合有助于矽肺的正确诊断。

Objective To compare the role between chest radiography（CR）,conventional CT（CCT） and high-resolution CT（HRCT） in the diagnosis of silicosis and its complications.Methods A hundred and seventy-three patients with silicosis identified by the Shanxi Provincial Peumoconiosis Diagnosis Group underwent CR,CCT and HRCT examinations.All the data acquired from above three techniques were comparatively analyzed.Results The assessable imaging findings in the group patients included intrapulmonary small opacities,big opacities,thickening of the lobular septa,reticular and honeycombed opacities,subpleural curvilinearity,varied kinds of emphysema,pleural thickening,intralesional calcification,lymph node enlargement of the pulmonary hilus and mediastinum,thickening of the main pulmonary arteries,or associated with tubercular foci.HRCT in visualizing small opacities,interstitial fibrosis of the lung,emphysema etc were significantly superior to CR and CCT,while CR in visualizing big opacities,interstitial fibrosis of the lung,emphysema,and pleural changes were inferior to CCT and HRCT.Conclusion Transthoracic CT,especially HRCT scans play important role in the diagnosis of silicosis.The combination of the three techniques can significantly elevate the diagnostic accuracy of silicosis.