直接数字化X线摄影技术在诊断职业性尘肺病中的应用价值分析

Analysis of application value of direct radiography(DR)in diagnosis of occupational pneumoconiosis

目的探讨分析直接数字化X线摄影(DR)技术在诊断职业性尘肺病中的应用价值。方法选取2017年9月~2018年9月于我所进行检查的工作中经常接触矽尘的93例从业人员作为本研究的受检者,对所有受检者均同时采用直接数字化X线摄影技术和高千伏X线摄影技术进行胸部检查,比较两种摄影方法所得胸片的质量,并对分布于肺区小阴影的数目、阴影密集度以及职业性尘肺病的疾病分期等的一致性进行分析。结果DR检查的胸片质量等级分布情况高于HKV检查,差异有统计学意义(P<0.05)。93例受检者中,共有肺区558个,其中DR、HKV两种检查的肺区小阴影数目分别为334个(59.86%,334/558)、289个(51.79%,289/558),两组差异无统计学意义(P>0.05)。DR检查的胸片小阴影总密集度分布等级要高于HKV检查,差异有统计学意义(P<0.05)。DR检查的职业性尘肺病的阳性率为19.35%,高于HKV的8.60%,差异有统计学意义(P<0.05)。结论运用DR摄影技术拍摄职业性尘肺胸片图像质量更好,小阴影密集度的检出率更高,有助于提高尘肺病的检出率并明确其诊断与分期,减少漏诊误诊几率,且降低受检者辐射剂量,值得临床深入推广应用。

Objective To explore the application value of direct radiography(DR)in diagnosis of occupational pneumoconiosis.Methods Ninety-three practitioners who were exposed frequently to silicious dust during work and came to our institute for examination from September 2017 to September 2018 were selected as the subjects of this study.Chest examination was performed on all subjects with both direct radiography and High KV Radiography.The quality of chest radiographs obtained by the two methods of photography were compared and the consistency of the number of small shadows distributed in the lung area,the intensity of the shadows,and the disease staging of occupational pneumoconiosis were analyzed.Results The quality of chest radiographs examined by DR was higher than that of HKV,and the difference was statistically significant(P<0.05).Among the 93 subjects,there were 558 lung zones.Among them,the numbers of small shadows detected by DR and HKV were 334(59.86%,334/558)and 289(51.79%,289/558),respectively.There was no significant difference between the two groups(P>0.05).The total intensity distribution of small shadows in the chest radiograph detected by DR was higher than that detected by HKV,and the difference was statistically significant(P<0.05).The positive rate of occupational pneumoconiosis detected by DR was 19.35%,which was higher than that detected by HKV(8.60%).The difference was statistically significant(P<0.05).Conclusion The quality of chest radiographs is better when using DR photography to detect occupational pneumoconiosis,and the detection rate of small shadow density is higher.This will help to improve the detection rate of occupational pneumoconiosis,clarify its diagnosis and staging,reduce the probability of missed diagnosis and misdiagnosis,and reduce the radiation dose received by the subjects,which is worthy of clinical application.