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目的探讨多层螺旋计算机断层扫描(MSCT)多平面重建技术在尘肺病病例肺动脉主干直径测量中的可行性。方法采用随机抽样方法,对334例尘肺病病例在MSCT多平面重建图像上测量肺动脉主干与升主动脉直径,比较不同工种、接尘时间、尘肺病期别、合并肺气肿以及融合块形成组间病例的肺动脉主干直径,分析其肺动脉高压(PAH)发生的分布情况及差异。结果尘肺叁期组病例肺动脉主干直径分别高于尘肺壹期组和尘肺贰期组病例(P<0.05);合并肺气肿和伴发融合块形成病例的肺动脉主干直径分别高于无合并肺气肿、无融合块形成者(P<0.01)。334例尘肺病病例中,发生PAH者76例(发生率为22.8%)。尘肺叁期组病例PAH发生率分别高于尘肺壹期组和尘肺贰期组病例(P<0.05)。合并肺气肿和伴发融合块形成病例的PAH发生率分别高于无合并肺气肿、无融合块形成者(29.4%vs 17.1%,29.9%vs 15.0%,P<0.01)。不同工种和接尘时间组病例PAH发生率分别比较,差异均无统计学意义(P>0.05)。结论 MSCT多平面重建技术有助于更精确地测量肺动脉主干直径。影响肺动脉主干直径的因素包括尘肺病期别、合并肺气肿及伴发融合块形成,而且该3种因素对PAH的发生有影响。
Objective To investigate the feasibility of multislice spiral computed tomography (MSCT) multiplanar reconstruction in the measurement of pulmonary artery trunk diameter in patients with pneumoconiosis. Methods The diameters of the main and ascending aorta of pulmonary arteries were measured in 334 cases of pneumoconiosis with MSCT on the basis of random sampling method. The different types of pneumoconiosis, dust exposure time, pneumoconiosis, emphysema and fusion block formation were compared Between the cases of pulmonary artery diameter, analysis of pulmonary hypertension (PAH) occurred in the distribution and differences. Results The diameters of the main pulmonary arteries in the third stage of pneumoconiosis group were higher than those in the first stage of pneumoconiosis group and the second stage of pneumoconiosis group (P <0.05), respectively. The diameter of the main pulmonary artery with emphysema and concomitant fusion block formation was significantly higher Swollen, no fusion block formation (P <0.01). Of the 334 cases of pneumoconiosis, 76 were found to have PAH (incidence 22.8%). The incidence of PAH in stage Ⅲ pneumoconiosis was higher than that in stage one and stage Ⅱ pneumoconiosis (P <0.05). The incidence of PAH in cases with emphysema and concomitant fusion mass was significantly higher than those without pulmonary emphysema (29.4% vs 17.1%, 29.9% vs 15.0%, P <0.01), respectively. There was no significant difference in the incidence of PAH among different types of workers and the time of dust collection (P> 0.05). Conclusion The MSCT multiplanar reconstruction technique can be used to more accurately measure the diameter of the pulmonary artery. Factors that affect the diameter of the main pulmonary artery include pneumoconiosis, emphysema and concomitant fusion block formation, and these three factors have an impact on the occurrence of PAH.