双能减影技术在职业性尘肺病诊断中应用  

Application of dual-energy subtraction technique in diagnosis of occupational pneumoconiosis

作　　者：谢媛琳 黄丽明 邓雪凝 陈伟波 邹珊 陈卫国[1] XIE Yuan-lin;HUANG Li-ming;DENG Xue-ning;CHEN Wei-bo;ZOU Shan;CHEN Wei-guo(Nanfang Hospital Southern Medical University,Guangzhou,Guangdong 510515 China;不详)

机构地区：[1]南方医科大学南方医院,广东广州510515 [2]佛山市三水区疾病防治所,广东佛山528100

出　　处：《中国职业医学》2022年第2期206-210,共5页China Occupational Medicine

基　　金：佛山市卫生健康局医学科研项目(20200390)。

摘　　要：目的探讨胸部双能减影(DES)技术在职业性尘肺病(以下简称“尘肺病”)诊断中的应用价值。方法采用随机抽样方法,选择86例疑似尘肺病患者和21例粉尘作业人员为研究对象,采用胸部数字化X射线摄影(DR)技术和DES技术分别拍摄后前位胸片,比较DR组、DES组和联合组胸片阅片结果的差异。结果DR组胸片的优片率高于DES组(72.9%vs 56.1%,P<0.05)。DES组、联合组胸片对阴影形态与大小、总体密集度和尘肺病期别的判定结果与DR组的一致性均较好(Kappa值均>0.75,P值均<0.01),但该两组对于小阴影密集度、小阴影聚集和大阴影分布的判定结果与DR组的一致性一般(Kappa值分别为0.67、0.74,P值均<0.01)。DES组和DR组胸片对小阴影密集度、小阴影聚集和大阴影分布的判定结果比较,差异无统计学意义(P>0.05);但联合组胸片该指标分别与DES组和DR组比较,差异均有统计学意义(P值均<0.01)。3组胸片对阴影形态与大小、总体密集度和尘肺病期别的判定结果分别比较,差异均无统计学意义(P值均>0.05)。结论与金标准DR比较,单纯DES和DES联合DR对于尘肺病诊断时的阴影形态与大小、总体密集度和尘肺病期别的判定结果均无差异。DES对于尘肺病诊断的价值有待进一步研究。ObjectiveTo explore the application value of chest dual-energy subtraction(DES)technology in the diagnosis of occupational pneumoconiosis.MethodsA total of 86 patients with suspected pneumoconiosis and 21 dust-exposure workers were selected as the research subjects using random sampling method.The posterior and anterior chest radiographs were taken by digital radiography(DR)and DES technology,and the difference of chest radiographs of DR,DES and combined groups were compared.ResultsThe positive rate of superior chest radiographs in DR group was higher than that in DES group(72.9%vs56.1%,P<0.05).The determination of shadow shape and size,total density and stage of pneumoconiosis on chest radiographs in DES group and combined group were consistent with those in DR group(all Kappa values>0.75,all P<0.01).However,the judgment of small shadow intensity,small shadow aggregation and large shadow distribution in the two groups were not superior to those in the DR group(Kappa value was 0.67,0.74,both P<0.01).There was no significant difference between DES group and DR group in the determination of small shadow intensity,small shadow aggregation and large shadow distribution(P>0.05).However,there were statistically significant difference in this index between the combined group and DES group and DR group(all P<0.01).There was no statistically significant difference in shadow shape and size,total density and stage of pneumoconiosis in chest radiographs among these three groups(all P>0.05).ConclusionThere was no difference between DES alone and DES combined with DR for the diagnosis of pneumoconiosis in terms of shadow shape and size,total density and stage of pneumoconiosis when compared with the gold standard DR.The value of DES in the diagnosis of pneumoconiosis needs further study.

关 键 词：尘肺病 数字化X射线摄影 双能减影 一致性 诊断 应用价值 

分 类 号：R135.2[医药卫生—劳动卫生]