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目的探讨CT/高分辨率CT(CT/HRCT)对煤工尘肺(CWP)大阴影的诊断价值。方法对62例CWP作胸部CT/HRCT扫描,并与X线胸片进行比较。结果62例CWP X线胸片检出大阴影19例,检出率为30.6%,共检出大阴影30个;CT/HRCT检出大阴影者43例,检出率为69.4%,共检出大阴影123个。CT/HRCT较X线胸片多检出大阴影93个(4.1倍)。2种检查方法的大阴影检出率比较,差异有统计学意义(x~2=18.58,P<0.01)。无一例X线胸片上显示大阴影而CT/HRCT未能显示者。62例CWP X线胸片检出Ⅲ期大阴影(≥1.0 cm×2.0 cm)者17例,检出率为27.4%,共检出Ⅲ期大阴影27个;CT/HRCT检出Ⅲ期大阴影34例,检出率为54.8%,共检出Ⅲ期大阴影67个,CT/HRCT比X线胸片多检出Ⅲ期大阴影40个,2种检查方法的大阴影检出率比较,差异有统计学意义(x~2=9.63,P<0.01)。CT/HRCT对大阴影的形态、内部结构、边缘特征、尘肺微细病变及特殊位置的大阴影均具有良好的显示能力。结论CT/HRCT在复杂性尘肺的诊断能力明显优于X线胸片,可检出X线胸片所不能发现的大阴影,可作为尘肺的一种重要而有实用价值的辅助检查手段。
Objective To investigate the diagnostic value of CT / HRCT in large shadows of coal worker’s pneumoconiosis (CWP). Methods Totally 62 cases of CWP were scanned by CT / HRCT and compared with X - ray. Results Sixty-two cases with large shadow were detected by CWP X-ray in 19 cases, with a detection rate of 30.6%. A total of 30 large shadows were detected. In 43 cases with large shadow detected by CT / HRCT, the detection rate was 69.4% 123 large shadow. CT / HRCT more than X-ray detection of large shadow 93 (4.1 times). There was significant difference between the two methods of detecting large shadow (x ~ 2 = 18.58, P <0.01). None of the cases showed a large shadow on the X-ray and CT / HRCT failed to show. Sixty-two cases of CWP X-ray were detected in 17 cases with stage Ⅲ large shadow (≥1.0 cm × 2.0 cm), the detection rate was 27.4% .Among 27 stage Ⅲ large shadows were detected, while stage Ⅲ was detected by CT / HRCT In 34 cases, the detection rate was 54.8%. A total of 67 large phase Ⅲ shadows were detected. CT / HRCT detected 40 large phase Ⅲ shadows more than X-ray. , The difference was statistically significant (x ~ 2 = 9.63, P <0.01). CT / HRCT has a good display ability on the shape of large shadow, internal structure, edge features, small lesions of pneumoconiosis and large shadow in special positions. Conclusion CT / HRCT is superior to X-ray in diagnosis of complex pneumoconiosis. It can detect the large shadow that can not be found on X-ray and can be used as an important and practical auxiliary examination method for pneumoconiosis.