MSCT与高千伏胸片对尘肺诊断的对比研究

A comparative study on MSCT and high kilovoltage chest radiography in diagnosis of pneumoconiosis

目的对比高千伏胸片与多层螺旋CT(MSCT)诊断尘肺的差异,以提高尘肺诊断水平。方法回顾性分析28例各期尘肺病患者高千伏胸片与MSCT图像,分组分析二者对尘肺病诊断的差异,对各类尘肺影像征象进行分组比较和统计处理。结果高千伏胸片组诊断尘肺病观察病例7例,Ⅰ期尘肺8例,Ⅱ期尘肺7例、Ⅲ期尘肺6例;MSCT组诊断Ⅰ期尘肺11例,Ⅱ期尘肺9例,Ⅲ期尘肺8例;两组差异有统计学意义(χ2=8.009,P=0.046)。MSCT组与高千伏胸片组在尘肺小阴影显示、小阴影聚集、大阴影内部结构、小叶间隔增厚及肺纤维化、胸膜下透光带、肺门及纵膈淋巴结钙化、阴影分布肺区总数、阴影密集度、部分并发症的显示方面差异有统计学意义(P<0.05)。结论 MSCT比高千伏胸片诊断尘肺病具有明显优势和重要价值,应将其纳入尘肺病诊断标准。

[ Objective ] To compare the difference between MSCT and high kilovoltage （ KV ） chest radiography in diagnosis of pneu- moconiosis, improve the level of pneumoconiosis diagnosis. [ Methods ] A retrospective analysis was performed to investigate the MSCT and high KV chest radiography images of 28 patients with pneumoconiosis, and compare the differences in diagnosis of pneu- moconiosis between these two methods. The group comparison and statistical analysis were conducted to explore the images and signs of pneumoconiosis. [ Results ] By the high KV chest radiography, there were 7 cases of suspected pneumoconiosis, 8 cases of phase Ⅰ, 7 cases of phase Ⅱ, 6 cases of phase Ⅲ. By MSCT, there were 11 cases of phase Ⅰ, 9 eases of phase Ⅱ, and 8 cases of phase Ⅲ. The difference between the two groups was statistically significant （ χ2 = 8. 009, P = 0.046 ）. MSCT is better than high KV chest radiography in the display of small shadow, small shadow aggregation, internal structure of big shadow, pulmonary lobules septal thickening and pulmonary fibrosis, subpleural photic zone, calcification of pulmonary hilum and mediastinal lymph node, total number of shadow distribution in lung region, as well as shadow intensity and complications, and the differences were statistical- ly significant （ P 〈 0.05 ）. [ Conehmion] MSCT shows the obvious advantage and important value than high KV chest radiography in diagnosis of pneumoconiosis, which should be included into the diagnostic criteria of pneumoconiosis.