电焊工与其他粉尘作业者的肺部高分辨率CT比较  

Pneumoconiosis in Arc Welder and Other Occupation：Comparative Study with High Resolution CT

作　　者：赵殿辉[1] 万卫平[1] 王忠诚[2] 陈达民[2] 汪晓婷[2] 陈雷[1] 

机构地区：[1]上海市闸北区中心医院放射科,上海200070 [2]上海市疾病预防控制中心体检站

出　　处：《实用放射学杂志》2009年第10期1438-1440,1449,共4页Journal of Practical Radiology

基　　金：上海市闸北区中心医院“789”人才学科攀登计划基金资助项目（编号：08重点-01）.

摘　　要：目的探讨高分辨率CT（HRCT）在电焊工及其他尘肺诊断中的价值。方法对289例不同粉尘作业者进行肺部HRCT检查，平均年龄44．0岁，平均工龄13．1年。采用GENX／i螺旋CT扫描仪，深吸气末HRCT采用层厚1～2mm，间隔10mm，轴面扫描，扫描速度1s／r，高分辨率重建。分析HRCT的异常表现。结果289例粉尘作业者中121例（41．9％）肺部HRCT表现为分支状细线影，47例（16．3%）可见边缘清晰结节，与分支状细线影形成“树芽征”表现。28例（9．7％）表现为磨玻璃密度结节，位于小叶中心，边缘模糊。18例（6．2％）肺内可见磨玻璃影。矽尘较焊尘更易出现肺结构扭曲异常（χ^2=11．649，P〈0．05）。焊尘较矽尘和其他粉尘较少引起肺气肿改变（χ^2=24．457，P〈0．05）。结论HRCT可显示尘肺早期表现，对纤维化病变的评价有一定的价值。Objective To evaluate the value of high resolution CT （HRCT） in diagnosing pneumoconiosis in arc welder and other occupation. Methods 289 workers with average age of 44 years and average history of dust exposure in 13.1 years underwent HRCT scanning during breath hold after deep inspiration with a model Hispeed Nx/i scanner （GE Medical Systems） at 10 mm intervals by using 2 mm collimation. CT data were reconstructed with high-spatial-frequency. CT features were analysed. Results HRCT findings were branching linear structure （ 121/289, 41.9 % ） , tree- in- bud （47/289, 16.3 % ） , poorly- defined ground- glass attenuation centrilohular micronodules （ 28/289 , 9.7% ） , patch of ground-glass attenuation （ 18/289 , 6.2% ） , emphysema （54/289, 18.7% ） . Distortion of lung architecture could be seen commonly in silicosis than arc welder＇s pneumoconiosis （χ^2= 11. 649 ,P〈 0.05 ） . Emphysema could be depicted fewer in arc welder＇s than silicosis and other pneumoconiosis （ χ^2 = 24. 457 ,Z2 = 24. 457,P 〈0.05）. Conclusion The pneumoconiosis can be detected early with HRCT. HRCT is of certain value in the assessment of fibrosis in pneumoconiosis.

关 键 词：肺 尘肺 体层摄影术 X线计算机 

分 类 号：R135.2[医药卫生—劳动卫生] R814.42[医药卫生—公共卫生与预防医学]