尘肺病HKV胸片X射线形态学特征分析

Morphological features analysis of high kV chest radiographs of pneumoconiosis

目的探讨不同尘肺病高千伏(HKV)胸片X线形态学特征,为修订尘肺病诊断标准提供依据。方法采用回顾性调查方法,按照最新尘肺病诊断标准,对3 689例尘肺病胸片X线形态学进行分析,并将结果建立数据库,用SPSS 17.0软件进行统计分析。结果基于3 689例尘肺病X线形态学改变结果分析,圆形小阴影表现为:p影508例(13.8%),q影1 501例(40.7%),r影279例(7.6%);不规则小阴影表现为:s影246例(6.7%),t影1 414例(38.3%);大阴影280例(7.6%),小阴影聚集196例(5.3%)。小阴影肺区分布主要在两肺中下肺区;各种尘肺病同时伴有肺纹理(60.3%)、肺门(35.5%)、胸膜(11.4%)、肺气肿(16.7%)等X线异常征象。结论 HKV胸片大阴影、小阴影形态、分布以及小阴影密集度的判定等,在尘肺病诊断分期中至关重要,分析发现,胸膜、肺门、肺纹理、肺气肿、肺结核等X射线影像学特征,与尘肺诊断密切相关,具有重要参考价值。

[Objective]To study the morphology features of high kV（HKV） chest radiographs,and provide evidence for the amendments of pneumoconiosis diagnostic criteria.Using retrospective survey methods,the chest X-ray morphological characteristics of the 3689 cases of pneumoconiosis were analyzed according to the latest standards of pneumoconiosis diagnosis,the database was established and statistical analysis done with SPSS 17.0 software.[Results]It was indicated from the X-ray analysis on 3 689 cases of pneumoconiosis that small round opacities showed 508 cases of type p（13.8%）,1 501 cases of type q（40.7%） and 279 cases of type r（7.6%）,a small irregular opacities showed 246 cases of type s（6.7%） and 1 414 cases of type t（38.3%）,and 280 cases of large opacities（7.6%） and 196 cases of confluence of small opacities（5.3%）.Small opacities located mainly in the mid and lower zones of both lungs,these pneumoconiosis accompanied with a variety of abnormal X-ray signs in markings（60.3%）,hilus of lung（35.5%）,pleura（11.4%）,emphysema（16.7%）.[Conclusion]Big opacities,shape and distribution of small opacities and density to determine in HKV chest radiograph are essential in diagnosis and classification of pneumoconiosis.It is found in the study that the x-ray imaging features,pleural,hilus,markings,emphysema,tuberculosis and others is closely related to pneumoconiosis diagnosis and has important reference value.