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目的对比高千伏胸片与多层螺旋CT(MSCT)诊断尘肺的差异,以提高尘肺诊断水平。方法回顾性分析28例各期尘肺病患者高千伏胸片与MSCT图像,分组分析二者对尘肺病诊断的差异,对各类尘肺影像征象进行分组比较和统计处理。结果高千伏胸片组诊断尘肺病观察病例7例,Ⅰ期尘肺8例,Ⅱ期尘肺7例、Ⅲ期尘肺6例;MSCT组诊断Ⅰ期尘肺11例,Ⅱ期尘肺9例,Ⅲ期尘肺8例;两组差异有统计学意义(χ2=8.009,P=0.046)。MSCT组与高千伏胸片组在尘肺小阴影显示、小阴影聚集、大阴影内部结构、小叶间隔增厚及肺纤维化、胸膜下透光带、肺门及纵膈淋巴结钙化、阴影分布肺区总数、阴影密集度、部分并发症的显示方面差异有统计学意义(P<0.05)。结论 MSCT比高千伏胸片诊断尘肺病具有明显优势和重要价值,应将其纳入尘肺病诊断标准。
Objective To compare the differences between high kvv chest radiographs and multislice spiral CT (MSCT) in diagnosing pneumoconiosis and improve the diagnostic accuracy of pneumoconiosis. Methods A retrospective analysis of 28 cases of pneumoconiosis patients with high kV chest X-ray images and MSCT, the group analysis of the differences between the two pneumoconiosis diagnosis of various types of pneumoconiosis imaging signs were grouped and statistical analysis. Results 7 cases of pneumoconiosis were diagnosed in high kV chest radiograph, 8 cases of pneumoconiosis in stage Ⅰ, 7 cases of pneumoconiosis in stage Ⅱ and 6 cases of pneumoconiosis in stage Ⅲ. MSCT group diagnosed 11 cases of pneumoconiosis in stage Ⅰ, 9 cases of pneumoconiosis in stage Ⅱ, Pneumoconiosis in 8 cases; the difference between the two groups was statistically significant (χ2 = 8.009, P = 0.046). In the MSCT group and the high-kV chest radiograph, small shadows of pneumoconiosis, small shadows, large shadows, thickening of the interlobular septa and pulmonary fibrosis, translucency of the subpleural spaces, calcification of the hilar and mediastinal lymph nodes, There were significant differences in the total area, shadow density and some complications (P <0.05). Conclusion MSCT has the obvious advantages and important value in diagnosing pneumoconiosis than high kV chest radiography. It should be included in the diagnostic criteria of pneumoconiosis.