张柏林, 雷益, 纪祥. 多排螺旋CT诊断职业性尘肺病的价值评价[J]. 职业卫生与应急救援, 2019, 37(3): 218-221. DOI: 10.16369/j.oher.issn.1007-1326.2019.03.003
引用本文: 张柏林, 雷益, 纪祥. 多排螺旋CT诊断职业性尘肺病的价值评价[J]. 职业卫生与应急救援, 2019, 37(3): 218-221. DOI: 10.16369/j.oher.issn.1007-1326.2019.03.003
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ZHANG Bolin, LEI Yi, JI Xiang. Evaluation of multi-row spiral CT in diagnosis of occupational pneumoconiosis[J]. Occupational Health and Emergency Rescue, 2019, 37(3): 218-221. DOI: 10.16369/j.oher.issn.1007-1326.2019.03.003
Citation: ZHANG Bolin, LEI Yi, JI Xiang. Evaluation of multi-row spiral CT in diagnosis of occupational pneumoconiosis[J]. Occupational Health and Emergency Rescue, 2019, 37(3): 218-221. DOI: 10.16369/j.oher.issn.1007-1326.2019.03.003
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多排螺旋CT诊断职业性尘肺病的价值评价

Evaluation of multi-row spiral CT in diagnosis of occupational pneumoconiosis

    摘要
  • 摘要:
    目的 研究探讨多排螺旋计算机断层扫描（computed tomography，CT）在职业性尘肺病患者诊断中的临床应用价值。
    方法 对99例疑似职业性尘肺病患者实施胸部DR检查、多排螺旋CT（简称CT）检查，以临床确诊结果为参照，对其诊断结果进行比较分析。
    结果 99例疑似职业性尘肺病患者中，有65例患者经临床确诊为职业性尘肺病，其中DR检查出63例，CT检查出62例。确诊为非尘肺病患者中，有1例被DR检查为尘肺病，2例被CT检查为尘肺病。以临床确诊结果为参照，DR、CT对尘肺病诊断的灵敏度、特异度、符合率差异均无统计学意义（P > 0.05）。CT对职业性尘肺病壹期的阳性检出率高于DR（P < 0.05），而DR、CT对尘肺病贰期、叁期的阳性检出率差异均无统计学意义（P > 0.05）。在职业性尘肺病患者的肺大疱、肺气肿、肺部感染、胸膜肥厚粘连等并发症诊断中，DR、CT的阳性检出率差异均无统计学意义（P > 0.05）。经一致性分析，DR、CT诊断结果与临床确诊结果间的一致性分别为0.933、0.956，均达到良好。
    结论 多排螺旋CT在职业性尘肺病诊断中具有良好的临床价值，可对职业性尘肺病及其并发症予以灵敏检出，还可对职业性尘肺病分期予以准确鉴别。

     

    Abstract:
    Objective To investigate the clinical value of multi-row spiral computed tomography (CT) in the diagnosis of occupational pneumoconiosis.
    Methods  From January 2016 to July 2018, the digit X-ray (DR) and multi-row spiral CT (abbr. CT) examination of 99 patients suspected with occupational pneumoconiosis were performed and the results were compared with the definite diagnosis made by the certificated doctors.
    Results  Of 99 patients suspected with occupational pneumoconiosis, 65 were clinically diagnosed as occupational pneumoconiosis, among whom 63 and 62 cases were diagnosed by DR examination and CT, respectively. Among 34 negatively diagnosed cases, 1 and 2 cases were diagnosed as occupational pneumoconiosis by DR and CT examination, respectively. There was no significant difference in the sensitivity, specificity and accuracy of DR and CT examination in the diagnosis of pneumoconiosis (P > 0.05). However, CT examination detected more cases with occupational pneumoconiosis in the stage Ⅰ than DR examination(P < 0.05), while there was no statistical difference of detection of cases with occupational pneumoconiosis in the stage Ⅱ and Ⅲ(P > 0.05). There was no significant difference of the diagnosis of pulmonary bullae, emphysema, pulmonary infection, pleural hypertrophy and adhesion among the patients with occupational pneumoconiosis between DR and CT examination(P > 0.05). The consistency of DR and CT examination with definite diagnosis was 0.933 and 0.956, respectively.
    Conclusion  Multi-row spiral CT has a good clinical value in the diagnosis of occupational pneumoconiosis. It can be used for sensitive detection of occupational pneumoconiosis and its complications. It can also be used for accurate differentiation of occupational pneumoconiosis stages.

     

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