ILO尘肺胸片分类标准在间质性肺疾病中的应用

The Radiographic Description of Pneumoconiosis of International Labour Office Classicication in Diffuse Interstitial Lung Diseases

本文采用ILO尘肺胸片分类方法分析78例胸内结节病(Ⅱ、Ⅲ期)及25例特发性肺间质纤维化(IPF)的肺内病变情况.结果表明,两种疾病肺内病变均以线状影为主,次为混合影.上、中、下肺野病变依次加重,彼此间有明显差异.IPF上、中肺野病变重于胸内结节病相应肺野.胸内结节病Ⅲ期两下肺野病变密集度也高于Ⅱ期.同种疾病左、右两侧病变的类型和程度相似.ILO尘肺胸片分类方法有助于间质性肺疾病肺内病变的定性和定量分析.

The scheme of ILO (the International Labour Office) Classification used for pneumoconiosis was modified by McLoud to provide a new description for the type and severity of rediographic opacities of lung parenchymal infiltration in idoipathic pulmonary fibrosis (IFF) and sarcoidosis(sarc). We reviewed 78 cases of chest film with sarc (stage 1,1) and 25 cases with IFF. The interpretation of type and quantity of opacities is based on categories 'rounded' (p,q,r),'linear-irregular'(s,t,u), 'reticularnodular'(x,y,z), and 11 point scale for profusion (severity). The results showed that 'linear-irregular' opacities predominated (about 50%) both in sarc Ⅱ and in IFF while 38% in sarc Ⅲ. 'reticularnodular' opacities are secondly common (26. 6%-40%) in sarc Ⅱ and in IFF. 'rounded' opacities were unusual in IFF. But radiographic severity of 'profusion' in IFF is heavier than that in sarc Ⅱ or Ⅲ except that it is the similar grade in lower zonebetween IFF and sarc Ⅱ or Ⅲ. It is more severe in lower zone of sarc Ⅲ than that in sarc Ⅱ. The severity of 'profusion' is progressively greater from upper lung zone to lower part in both sarc and IFF. There is no significant difference in profusion severity between right and left field in sarc and IFF. This classification provides an understandable and quantifiable system of communication and a tool for clinical research and comparative study of diffuse interstitial lung disease. It is also a complement of Silzbach for staging sarc.