陶瓷工人胸部多层螺旋CT低剂量扫描的价值分析  

Value analysis of low dose multi-slice spiral CT scanning on chest examination of ceramic workers

作　　者：刘贵喜[1] 杨爱初[1] 熊刘珊[1] 陈丽琨[1] 陈朝东[1] 

机构地区：[1]广东省职业病防治院,广东广州510300

出　　处：《中国工业医学杂志》2013年第2期83-87,共5页Chinese Journal of Industrial Medicine

基　　金：广东省医学科研基金项目(A2012075)

摘　　要：目的将多层螺旋CT(MSCT)低剂量扫描用于接尘工人的职业健康监护,推动MSCT在尘肺病防治工作中的应用。方法对68例陶瓷工人志愿者同时做高仟伏胸片、胸部MSCT常规剂量与低剂量扫描检查,将其胸部影像表现进行对比分析。结果高仟伏胸片双肺未见异常13例,双肺纹理改变为主者19例,有一定数量的小阴影36例,其中q影21例,q/s影15例;MSCT常规剂量与低剂量扫描对小阴影的显示一致,均为54例,其中p/s影35例,q/s影19例,两者在显示小阴影改变、密集度分级与分布肺区判断等方面均明显优于高仟伏胸片。MSCT低剂量扫描对于显示圆形小阴影、短线影、小叶间隔增厚、磨玻璃影、小气道病变、胸膜下线影等病变,与常规剂量比较,差异无统计学意义(P>0.05),其辐射剂量约为常规剂量扫描的1/3～1/5。结论 MSCT低剂量扫描能够较全面和准确地反映粉尘所致肺部病变情况,其辐射剂量较常规剂量扫描大幅降低,安全性明显提高,用于粉尘作业人员的职业健康监护是可行的;唯成本较高,值得今后努力解决。Objective To use multi-slice spiral CT low dose scanning for occupational health surveillance in dust-exposed workers, thereby promote the application of muhi-slice spriral CT in prevention and control of pneumoconiosis. Methods Simultaneously using high-kV, MSCT conventional dose screening and MSCT low dose screening on the chests of 68 ceramic dustexposed volunteers, and compared and analyzed the manifestations of these chest images. Results Among high kV chest X-ray examination, 13 cases showed no abnormalities, 19 cases showed mainly the double markings change; 36 cases had a number of small opacities （21 cases were q type and 15 cases were q/s type）; conventonal dose MSCT screening and low dose MSCT screening had consistent result for small opacities, each was 54 cases （35 cases were p/s type and 19 cases were q/s type）, showed that both MSCT techniques were superior to high-kV chest radiograph whether in small opacities confirmation, its profusion classification or its lung area distribution. Additionally, in display those changes such as rounded small opacities, short line opacities, interlobular septal thickening, ground-glass shadow, small airway disease and subpleural linear shadow etc. , low dose MSCT scanning also showed good resolving power compared with conventional dose MSCT scanning, there was no statistical difference （P 〉 0. 05 ）, but its radiation dose was only the 1/3--1/5 of conventional dose： Conclusion Low dose MSCT scan- ning can comprehensively and exactly reflect various pathological changes in lung caused by dust, while the radiation dose is much reduced compared to conventional MSCT scanning, thereby the safety also get obviously raised, therefore, it is feasible to apply in Occupational health surveillance of dust-exposed workers, but the higher cost seems a big obstacle needed making great efforts to solve.

关 键 词：陶瓷工人 多层螺旋CT 低剂量 职业 健康监护 

分 类 号：R135.2[医药卫生—劳动卫生]