直接数字X线摄影在尘肺病诊断中的应用价值

The Clinical Value of Direct Digital Radiography in Diagnosing Pneumoconiosis

目的探讨直接数字X线摄影(DR)在尘肺病诊断中的应用价值。方法对随机抽取的298例接尘对象分批组织同期分别摄高仟伏和DR胸片,先由6名具有尘肺病诊断资质的医师随机均分甲、乙两组分别进行诊断,然后甲、乙两组合并阅片,使分组诊断不一致的结果得到统一。对DR和高仟伏两种胸片统一后诊断的胸片质量、小阴影的形态和大小、总体密集度、小阴影分布肺区数、尘肺分期等结果进行分析比较。结果 DR胸片质量等级集中在优片(97.99%),高仟伏胸片集中在良片(93.63%);DR胸片和高仟伏胸片小阴影的形态和大小、小阴影总体密集度、尘肺分期经一致性检验Kappa值分别为0.642、0.406、0.436,符合率分别为88.26%(263/298)、67.79%(202/298)、65.77%(196/298);小阴影分布肺区数在下肺区DR胸片明显多于高仟伏胸片。结论 DR胸片质量明显优于高仟伏胸片,可用于尘肺病的诊断。

Objective To discuss the clinical application of direct digital radiography （DR） in diagnosing pneumoconi- osis. Methods A total of 298 randomly selected participants were enrolled in this study. High-KV chest radiography and DR chest radiography were performed for participants in batches. First, six physicians with pneumoconiosis diagnosis quali- fication were randomly divided into group A and group B to make their diagnosis; then two groups made the diagnosis together to get the same conclusion. Finally, the quality of the images, the shape and size of small opacities, the total density, and the number of the small opacities in different lung zones and the stage of pneumoconiosis between the two groups were compared and analyzed. Results Excellent level quality of DR chest radiograph was up to 97.99% , while good lev- el quality of high-KV chest radiograph was 93.63%. The consistencies in the shape and size of small opacities, the total density of small opacities and the stage of pneumoconiosis between DR chest radiographs and high-KV chest radiographs were 88.26% （263/298, Kappa value = 0. 642 ） , 67.79% （202/298, Kappa value = 0.406） and 65.77% （ 196/298, Kappa value = 0. 436 ） respectively. DR chest radiograph displayed the small opacities, which were mainly distributed in the lower lung zone, obviously more than high-KV chest radiograph did. Conclusion The quality of DR chest radiograph is superior to the quality of high-KV chest radiograph, therefore, DR chest radiograph can be used for the diagnosis of pneumocomosls