Objective  To explore the value of multimodal imaging in the diagnosis of occupational pneumoconiosis.

  Methods  A total of 160 patients with occupational pneumoconiosis who were hospitalized from June 2018 to March 2021 were studied. All the subjects underwent high kilovolt radiography(HKV), digital radiography(DR), digital radiography combined with dual energy subtraction(DES) and high-resolution CT(HRCT). The consistency of the diagnostic staging results of these four examination methods for pneumoconiosis patients and the detection rates of pulmonary complications were compared, to evaluate the diagnostic efficacy of four methods in the diagnosis of pneumoconiosis.

  Results  HKV had medium consistency in the diagnosis of pneumoconiosis with kappa of 0.562 (95% CI: 0.471-0.652); The diagnostic results of DR and DES for pneumoconiosis were highly consistent with kappa of 0.669 (95% CI: 0.584-0.753) and 0.750 (95%CI: 0.677-0.823), respectively; HRCT was highly consistent in the diagnosis of pneumoconiosis with kappa of 0.882 (95% CI: 0.829-0.935) (P < 0.01). The detection rates of emphysema, bullae, pleural thickening and pleural effusion by these 4 methods were different (P < 0.05), while there was no significant difference in the detection rates of pulmonary tuberculosis (P > 0.05). The detection rates of emphysema, bullae, pleural thickening and pleural effusion by HRCT were higher than that by the other three methods (P < 0.05).

  Conclusions  These four methods have certain diagnostic efficacy in the diagnosis of occupational pneumoconiosis and its complications, and can be combined used to improve the accuracy of diagnosis and staging of pneumoconiosis.