两种影像学方法在Ⅱ期矽肺中的诊断价值

Diagnostic Value of Two Different Imaging Methods in Phase Ⅱ Silicosis

目的:探讨高千伏X线胸片和胸部高分辨CT(HRCT)在Ⅱ期矽肺中的诊断价值。方法:56例住院治疗的矽肺患者均分为2组,分别采用高千伏X线胸片及胸部HRCT检查,观察两种检查方法对矽肺患者肺部影像学特征及矽肺的检出率,并评价两种方法在矽肺分期中的价值。结果:高千伏X线胸片检查在斑片条、小阴影聚集和空洞方面检出率与HRCT比较差异无统计学意义(P>0.05);胸部HRCT对发白区、大结节影、钙化、灶周气肿、灶周结节、纤维索状条影和淋巴结肿大与钙化检出率高于高千伏X线胸片,差异有统计学意义(P<0.05);在矽肺分期方面,胸部HRCT优于高千伏X线胸片,差异有统计学意义(P<0.05)。结论:对于高千伏X线胸片无法确诊的疑似矽肺病例应进行HRCT检查,可提高矽肺患者的确诊率和明确分期。

Objective： To investigate the diagnostic value of high KV chest X-ray and high resolution CT （HRCT） in diagnosis of stage Ⅱ of silicosis. Methods： Fifty-six cases of patients with silicosis were divided into two groups, and one group was subjected to high KV chest X-ray examination and the other subjected to HRCT examination. The features of lung image and the detection rate of silicosis in the two groups were observed and diagnostic value was evaluated. Results： There was no statistical difference between high KV chest X-ray and high resolution CT （HRCT） examination in detection rate of spot strip, small shadow aggregation and pulmonary cavity （ P 〉 0.05 ）. However, the detection rate of HRCT was higher than that of high KV chest X-ray in white areas, large nodules, calcification, perifocal emphysema, peripheral nodules, fiber cord like a shadow and lymph node enlargement and cal cification, and the differences were statistically significant （P 〈 0.05 ）. In staging of silicosis stages, HRCT was significantly better than high KV chest X-ray （ P 〈 0.05 ）. Conclusion： Those suspected silicosis cases unable to identify by high KV X-ray examination should be examined by HRCT, which to a greater extent can improve the accurate diagnosis rate of silicon lung patients.