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目的通过胸部高仟伏平片摄影(HKV片)和胸部高分辨率电子计算机X射线断层扫描(HRCT)联合应用的方法研究尘肺的早期诊断。方法 在粉尘作业职业健康监护对象中选择显示肯定或可疑尘肺X线表现的HKV片共计178例,通过比对国家尘肺诊断标准片,分别划分出尘肺壹期(22例)、无尘肺(51例)、观察期A组(65例)、观察期B组(40例)共四组。HKV片检查后2～4周内进行HRCT检查,并结合HRCT表现再分组,比较仅根据单独HKV片与结合HRCT检查结果两种判断方法在尘肺诊断上的区别。结果 HRCT在诊断中对HKV片具有验证作用,有减少假阳性和假阴性的作用;HKV片结合HRCT进行诊断分组可使尘肺的诊断正确率明显提高(且具有统计学意义),使无尘肺组受检者早期小阴影改变得以明确(共28例,占总例数15.73%)。结论在粉尘作业职业性健康监护中,HKV片和HRCT的联合应用,不仅能提高尘肺的诊断率,而且能在无尘肺对象中发现、验证或确定尘肺小阴影的存在,有助于尘肺的早期影像学诊断。
Objective To study the early diagnosis of pneumoconiosis through the combination of chest radiography (HKV film) and chest high-resolution computerized tomography (HRCT). Methods A total of 178 cases of HKV films were selected from the occupational health monitoring objects for dusty operation. Fifty-seven cases of pneumoconiosis (22 cases), pneumoconiosis (51 cases ), Observation group A (65 cases), observation group B (40 cases) a total of four groups. HKV examination after 2 to 4 weeks for HRCT examination, combined with HRCT performance and then subdivided, compared with only based on separate HKV tablets combined with HRCT test results of two judgments in the difference between the diagnosis of pneumoconiosis. Results HRCT could be used as a validator in the diagnosis of HKV, which could reduce false positive and false negative. HRV combined with HRCT could improve the diagnostic accuracy of pneumoconiosis (with statistical significance) Subjects early small changes in the shadow to be clear (a total of 28 cases, 15.73% of the total number of cases). Conclusions The combined application of HKV film and HRCT in dust occupational occupational health monitoring can not only improve the diagnostic rate of pneumoconiosis but also find, verify or confirm the existence of small pneumoconiosis in non-pneumoconiosis patients and contribute to the early stage of pneumoconiosis Imaging diagnosis.