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目的:探讨高千伏X线片、CT、高千伏DR联合应用在尘肺病鉴别诊断中的应用价值。为我国在尘肺病诊断工作中推广应用DR等数字化技术提供基础资料。方法:选择208例具有明确职业性生产粉尘接触病史患者,对每个研究对象拍摄胸部高千伏X线片。应用相同投照条件同期拍摄高千伏DR片,及薄层CT胸部扫描。具有尘肺诊断资质的三名以上医师共同阅片,观察和比较高千伏胸片、DR胸片、CT的尘肺病征象表现,分析总结三者联合应用在尘肺病诊断和鉴别诊断等方面价值。结果:高千伏胸片、DR、CT联合应用在总体密集度分值、肺区数分值、小阴影聚集或大阴影分值、合并症分值、诊断分期分值优于高千伏胸片。差异均有统计学意义(P<0.01)。结论:胸部高千伏X射线平片与高千伏DR片、薄层CT扫描在尘肺病诊断、鉴别诊断中各有优缺点,若三者联合应用,可以互相弥补各自的不足,更加客观的反映疾病状态,使尘肺病诊断更加准确。
Objective: To investigate the value of combined application of high kV radiography, CT and high kV DR in the differential diagnosis of pneumoconiosis. For our country in the diagnosis of pneumoconiosis to promote the use of DR and other digital technology to provide basic information. METHODS: A total of 208 patients with a history of occupationally-exposed dust exposure were selected and high chest X-ray radiographs of the chest were taken on each subject. Apply the same projection conditions simultaneously shot high kV DR film, and thin layer CT chest scan. Three or more physicians with the qualification of pneumoconiosis were read together to observe and compare the signs of pneumoconiosis with high kV chest radiographs, DR chest radiographs and CT scans. The combined application of these three in pneumoconiosis diagnosis and differential diagnosis was summarized. Results: The combination of high kvv chest radiograph, DR and CT was better than the high Kv chest in the overall intensity score, lung area score, small shadow aggregation or large shadow score, comorbidity score sheet. The differences were statistically significant (P <0.01). Conclusion: Chest high kV radiographs and high kV DR films and thin-layer CT scans have their own advantages and disadvantages in the diagnosis and differential diagnosis of pneumoconiosis. If they are used in combination, they can make up for their deficiencies and become more objective Reflect the disease status, so pneumoconiosis diagnosis more accurate.