论文部分内容阅读
[目的]比较高分辨率CT(HRCT)和高千伏胸片对粉尘接触者肺部小阴影的显示能力。[方法]对137例(男性125例,女性12例)HRCT和高千伏胸片资料完整者的影像学资料进行回顾性分析。其中,接触焊尘者56例,接触矽尘者37例,接触其他粉尘(包括铝尘、炭黑、水泥等)者44例。HRCT采用2mm层厚、10mm间隔从肺尖至膈肌扫描,采用-700HU/1500HU的窗位/窗宽进行摄片和观察。HRCT和高千伏胸片在不知晓职业史的前提下分别进行读片。对胸片和HRCT评估获得的各肺区小阴影的密集度进行一一比较,并对小阴影总体密集度进行比较。[结果]HRCT对小阴影总体密集度的评估与胸片评估密切相关(r=0.655,P<0.01),但HRCT对小阴影的评估分辨率高于胸片(P<0.01)。115例HRCT显示小阴影,其中s影86例,p影5例,p/s影8例,s/p影15例,q影1例。86例胸片显示小阴影,其中s影25例,p影5例,p/s影28例,s/p影24例,q/p影3例,q/s影2例。86例胸片显示小阴影的工人中6例HRCT显示正常。50例胸片无小阴影的工人中,34例(68%)HRCT显示异常小阴影。HRCT显示了上肺区及背部小阴影的分布优势。[结论]胸部HRCT在小阴影早期检测方面可弥补胸片的不足,对于准确评估小阴影有一定价值。
[Objective] To compare the display ability of high-resolution CT (HRCT) and high-kv chest radiographs on small shadows of the lungs of dust-exposed patients. [Methods] The imaging data of 137 patients (125 males and 12 females) with complete data of HRCT and high kV chest radiographs were retrospectively analyzed. Among them, 56 were exposed to dust, 37 were exposed to silica dust, and 44 were exposed to other dusts (including aluminum dust, carbon black, cement, etc.). HRCT using 2mm layer thickness, 10mm interval from the apical to the diaphragmatic scan, using -700HU / 1500HU window / window width for filming and observation. HRCT and high-kv chest radiographs were read on the premise of not knowing the history of occupations. The intensities of small shades of lungs obtained from chest radiographs and HRCT assessments were compared one by one, and the overall intensity of small shadows was compared. [Results] The HRCT was closely related to the evaluation of chest radiography (r = 0.655, P <0.01). However, the resolution of HRCT for small shadows was higher than that of chest radiographs (P <0.01). 115 cases of HRCT showed a small shadow, of which s shadow in 86 cases, p in 5 cases, p / s in 8 cases, s / p in 15 cases, q in 1 case. There were 25 cases of s-shadow, 5 cases of p-shadow, 28 cases of p / s shadow, 24 cases of s / p shadow, 3 cases of q / p shadow and 2 cases of q / s shadow. Six of the 86 chest radiographs showed low-HRCT HRCT showed normal. Of the 50 chest radiograph-free workers, 34 (68%) HRCT showed abnormally small shadows. HRCT shows the superiority of the distribution of small shadows in the upper lung area and back. [Conclusion] Chest HRCT can make up the deficiency of chest radiograph in the early detection of small shadow, which is of certain value for accurate assessment of small shadow.