螺旋CT在煤工尘肺肺气肿诊断中的应用价值  

Role of spiral CT played in the diagnosis of emphysema in patients with coal pneumoconiosis

作　　者：李宝平[1] 邓茂松[1] 周云芝[2] 尹晓明[1] 曾庆玉[1] 霍健伟[1] 王洪武[2] 常鑫[1] 李晶[2] 

机构地区：[1]北京煤炭总医院影像科,北京100028 [2]北京煤炭总医院呼吸科,北京100028

出　　处：《中国工业医学杂志》2007年第2期82-85,共4页Chinese Journal of Industrial Medicine

摘　　要：目的探讨螺旋CT和高分辨率CT(HRCT)检出煤工尘肺肺气肿与肺功能检测指标的相关性及两种CT在煤工尘肺肺气肿检出方面的差异。方法选择96例Ⅰ期煤工尘肺患者行64排螺旋CT和HRCT扫描检查,并进行肺气肿定性及定量分析。肺功能检查(PFT)采用比利时麦迪公司(Mdeisoft)Bodybox5500体积描记仪测定通气功能和容积功能。用SPSS统计软件对两种CT与肺功能检查结果进行相关的统计学分析。结果64排螺旋CT和HRCT评分与肺功能检测指标中的RV、RV/TLC%、TLC有很好正相关(P<0.001);而FVC、DLCO、FEV1/FVC%、FEV1%、MVV均有很好负相关(P<0.001)。肺气肿64排螺旋CT和HRCT诊断的阳性率高于肺功能检出阳性率(P<0.005),两种CT肺气肿检出率经配对计数资料卡方检验,χ2=2.78,P>0.05,说明两种检查方法对肺气肿检出率无明显差异。结论64排螺旋CT和HRCT对肺气肿检出,与肺功能检测指标有很好的相关性(P<0.001),即64排螺旋CT和HRCT与肺功能检出肺气肿方面有同样敏感性;CT诊断肺气肿的阳性检出率高于肺功能,说明对于早期肺气肿诊断64排螺旋CT和HRCT检查优于肺功能检查。Objective To evaluate the diagnostic efficacy in the diagnosis of emphysema caused by coal worker＇s pneumoconiosis and the associativity with pulmonary functional indices between spiral CT and high resolution CT （HRCT）. Method 96 category I cases of coal worker＇s pneumoconiosis were selected for 64 row detectors spiral CT and HRCT examinations, qualitative and quantitative analyses for emphysema were made, additionally, the pulmonary ventilation and volume functions were also performed with Bodybox5500 Volume Scanner （Mdeisofi Co, Belgium）, using SPSS software to do statistical analysis on the diagnostic efficacy in diagnosis of emphysema and the associativity with pulmonary functional indices between spiral CT and HRCT. Remit There was a good positive correlation between the scores either from spiral CT or HRCT and the pulmonary functional indices such as RV, RV/TLC%, TLC （ P 〈 0.001 ）, meanwhile, the good negative correlation also existed with FVC, DLco, FEV1/FVC%, FEV1% and MVV （P 〈 0.001）. The positive diagnostic rates of emphysema by spiral CT and HRCT were much higher than that by pulmonary function test （P 〈 0.005）. The chi-square test （ χ^2 = 2.78, P 〉 0.05） demonstrated that there was no significant difference in the diagnostic rates of emphysema between spiral CT and HRCT. Conclusion There is a good correlation between the 64 row detectors spiral CT or HRCT and the pulmonary function test in diagnosis of emphysema （P 〈 0.001）, demonstrating the same sensitivity of these two imaging methods in diagnosis of emphysema, and the diagnositic rate of early emphysema even higher than that by pulmonary function test （P 〈 0.005）. There is no significant difference in diagnostic rate of emphysema between 64 row detectors spiral CT and HRCT.

关 键 词：64排螺旋CT 高分辨率CT(HRCT) 肺功能 肺气肿 

分 类 号：R814.42[医药卫生—影像医学与核医学] R135.2[医药卫生—放射医学]