尘肺病大阴影的影像学特点及其临床意义  

Image features and clinical significance of pneumoconiosis with large shadow

作　　者：蔡志春[1] 王思红[1] 陈艳霞 李春海[1] 赵娜[1] 阚兴铮 赵玉军[1] 

机构地区：[1]山东省职业卫生与职业病防治研究院,济南250002 [2]青岛市中心医疗集团职业病院

出　　处：《中华劳动卫生职业病杂志》2016年第3期214-217,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的探讨Ⅲ期尘肺病大阴影的影像学表现特点、分型及其临床意义。方法选择我院168例经尘肺专家组因≥2cm×1 cm大阴影而直接诊断为叁期尘肺病例的高仟伏胸片（DR）及CT扫描胸片的影像学表现进行比较。结果≥2cm×1 cm的Ⅲ期尘肺病大阴影具有明显的影像学特点，如分布双中上肺区（95．2％），形态不规则（97．6％），两侧呈“八字形”或“腊肠样”改变且多与肋骨垂直（89．2％），周围伴有尘肺小阴影（98．8．0％），动态观察大阴影可向肺门或上纵隔收敛移动（53．6％）。CT在灶周气肿、灶内空洞、纵隔淋巴结肿大检出率明显高于高仟伏（DR），差异有统计学意义（P〈0.05）。结论高仟伏胸片（OR）结合CT表现特点是确定尘肺病大阴影、从而直接诊断Ⅲ期尘肺病的主要方法；CT在其鉴别诊断方面具有重要价值。Objective To investigate the image features, categories, and clinical significances of Pneumoconiosis Ⅲ with large shadow. Methods The research is based on the analysis of image features of 168 pneumoconiosis Ⅲ patients who are directly diagnosed by qualified medical professionals in our institution. These image features are large shadows bigger than 2 cm×1 cm which can be observed by high kilovolt chest radiographs, DR chest radiography and chest CT scan. Results Large shadows bigger than 2×1 cm show noticeable imaging characteristics, like distribution of superior and middle lung regions （95.2%）, irregular shapes （97.6%）, splayed or sausage like changes on both sides perpendicular with ribs （89.2%）, small shadows of pneumoconiosis （98.8%）, and convergence of large shadow to hilum or mediastinal （53.6%）. CT scan is significantly better than DR radiography on detection rate of focal emphysema, focal cavities and swollen lymph node of mediastinal. Conclusion Combining the image features of high kilovolt chest radiographs, DR chest radiographs and CT scan are the main methods to identify the shadows, and thus direct diagnose pneumoconiosis HI ; CT scan plays an important role in differential diagnosis.

关 键 词：尘肺 放射摄影术 体层摄影术 疾病特征 

分 类 号：R135.2[医药卫生—劳动卫生]