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目的分析煤工尘肺大阴影的螺旋CT表现,探讨CT对伴有大阴影的尘肺的辅助诊段价值。方法回顾性分析60例煤工尘肺大阴影病例的螺旋CT表现,总结其大小、分布、密度、内部征象、周围征象、胸膜改变、纵隔及肺门淋巴结的CT特点。结果阴影最小者为15mm×12mm×23mm,最大者为64mm×53mm×52mm;多位于肺的背侧部内中带,右肺多于左肺;CT值范围47~87HU,平均值65HU;60例患者中伴有钙化灶者55例,8例可见空洞;周围征象:47例大阴影周围伴有小阴影,52例大阴影周围纤维索条影及毛刺样改变,43例大阴影周围肺气肿、肺大泡;胸膜改变:49例可见胸膜增厚、粘连、钙化、牵拉;纵隔及肺门淋巴结:58例可见纵隔及双肺门淋巴结增大、增多、钙化。结论螺旋CT可以明确显示尘肺大阴影的大小、分布、密度、内部征象、周围征象、胸膜改变、纵隔及肺门淋巴结特点,可作为临床诊断煤工尘肺大阴影的重要检查手段。
Objective To analyze the spiral CT findings of large shadow of coal workers’ pneumoconiosis and to explore the value of CT in the auxiliary diagnosis of pneumoconiosis with large shadow. Methods A retrospective analysis of 60 cases of coal workers with pneumoconiosis major spiral CT findings, and its size, distribution, density, internal signs, peripheral signs, pleural changes, mediastinal and hilar lymph nodes CT characteristics. Results in the smallest shadow of 15mm × 12mm × 23mm, the largest of 64mm × 53mm × 52mm; more in the dorsal midline with the lung, the right lung more than the left lung; CT range 47 ~ 87HU, an average of 65HU; 60 cases There were 55 patients with calcification in the patient, and 8 patients were found to be hollow. Peripheral signs: small shadow around 47 big shadow, small shadow around 52 big shadow and burr-like change, 43 cases of large emphysema around emphysema , Pleurodesis: pleural thickening, adhesions, calcification, traction in 49 cases; mediastinal and hilar lymph nodes: 58 cases of mediastinal and hilar lymph nodes increased, increased, calcification. Conclusion Spiral CT can clearly show the size, distribution, density, internal signs, peripheral signs, pleural changes, mediastinal and hilar lymph node characteristics of large shadow of pneumoconiosis, which can be used as an important checkpoint for clinical diagnosis of large shadow of coal worker’s pneumoconiosis.