MSCT检测尘肺患者主肺动脉直径改变的早期诊断意义

The early diagnostic value of multislice spiral computed tomograghy in patients with pneumoconiosis

目的探讨多层螺旋CT(MSCT)检测主肺动脉直径改变用于尘肺患者早期的临床诊断意义。方法选取2013年1月至2015年6月就诊的120例患者纳入研究,分为对照组(A组)、尘肺Ⅰ期组(B组)、尘肺Ⅱ期组(C组)和尘肺Ⅲ期组(D组),每组30例。对4组患者采用高千伏片和MSCT两种方法进行检测,高千伏片进行胸前后位检测,MSCT测定B、C、D组肺动脉直径、右肺动脉直径、左肺动脉直径、主动脉/升主动脉值、主动脉/降主动脉值。并且利用肺功能机测定患者第1秒最大呼气量占预计值的百分比。对两种检测方式的阳性结果进行比较,MSCT测定患者直径指标间进行比较,并且分析直径指标和第1秒最大呼气量占预计值百分比的相关性。结果 MSCT在早期图像诊断方面较高千伏片方法清晰可靠,对尘肺患者阳性检出率在早期诊断率高于高千伏胸片,且各个分期均有所提高,差异有统计学意义(P<0.05)。MSCT所测定的患者的肺动脉直径、左肺动脉直径、右肺动脉直径、主动脉/升主动脉值、主动脉/降主动脉值,且五项指标与EFV1%间呈现负相关关系(r=-0.31,-0.22,-0.27,-0.33,-0.37,P<0.05)。结论以检测肺动脉直径变化为指标,MSCT对于尘肺患者早期诊断具有一定的临床意义。

Objective To investigate the early diagnostic value of multislice spiral computed tomograghy（ MSCT） in patients with pneumoconiosis in different stages. Methods A total of 120 patients with pneumoconiosis who were treated in our hospital from January 2013 to June 2015 were enrolled in the study,these patients were divided into four groups： control group（ group A）,group B（ pneumoconiosis in stageⅠ）,groups C（ pneumoconiosis in stageⅡ）,group D（ pneumoconiosis in stage Ⅲ,with 30 patients in each group. All the patients underwent MSCT examination to measure pulmonary antery diameter,right pulmonary antery diameter,left pulmonary antery diameter,the ratio of aorta / ascending aorta and the ratio of aorta /descending aorta. Moreover the chest anteroposterior position examination was performed by high kilovolt slice method. Results The definition and reliability of early image diagnosis by MSCT were superior to those of higher kilovolt slice method,moreover,the early detection positive rate of pneumoconiosis by MSCT was significantgly higher than that of high kilovolt slice method（ P〈0. 05）. The five indexes detected by MSCT including pulmonary antery diameter,right pulmonary antery diameter,left pulmonary antery diameter,the ratio of aorta / ascending aorta and the ratio of aorta / descending aorta were negatively correlated to EFV1%（ r =-0. 31,-0. 22,-0. 27,-0. 33,-0. 37,respectively,P〈0. 05）. Conclusion MSCT has a certain clinical significance in early diagnosis of pneumoconiosis,which regards the changes of pulmonary antery diameter as indexes.