MSCT对粉尘作业引起的肺部弥漫性小结节的诊断及随访价值研究  

Study on the diagnostic and follow-up value of MSCT for diffuse small pulmonary nodules caused by dust exposure

作　　者：黄宁 伍武 黄建桂 HUANG Ning;WU Wu;HUANG Jian-gui(Department of Medical Imaging,the Sixth People's Hospital of Dongguan,Dongguan 523000,China)

机构地区：[1]东莞市第六人民医院医学影像科,523000

出　　处：《中国现代药物应用》2023年第24期69-72,共4页Chinese Journal of Modern Drug Application

基　　金：广东省东莞市社会发展科技项目(项目编号:20221800904702)。

摘　　要：目的 研究多层螺旋CT(MSCT)对粉尘作业引起的肺部弥漫性小结节的诊断及随访价值。方法 选取确诊为尘肺Ⅰ期的51例男性粉尘作业人员作为尘肺组,另选取同期、同厂房的51例男性工人作为接尘对照组,同一地区仪表厂、机电厂的51例健康男性作为健康对照组。三组研究对象均行X线胸片与MSCT扫描检查。比较三组MSCT定量及半定量指标(肺体积、肺密度值、肺气肿指数),肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)];分析MSCT定量及半定量指标与肺功能指标的相关性;比较尘肺组复诊时X线胸片与MSCT的检出情况。结果 健康对照组、接尘对照组、尘肺组的肺体积依次减小,肺密度值、肺气肿指数依次增高,三组组间比较差异有统计学意义(P<0.05)。健康对照组、接尘对照组、尘肺组的FVC、FEV1、FEV1/FVC均呈逐渐降低趋势,且组间各指标比较差异均有统计学意义(P<0.05)。FVC与肺体积及肺密度值无相关性(P>0.05), FVC与肺气肿指数呈负相关(r=-0.361, P<0.05);FEV1、FEV1/FVC与肺体积、肺密度值呈正相关(r=0.472、0.574、0.548、0.709, P<0.05), FEV1、FEV1/FVC与肺气肿指数呈负相关(r=-0.662、-0.739, P<0.05)。尘肺组随访2年复诊时MSCT对小结节增大、小结节增多、灶性肺气肿和钙化淋巴结的检出率分别为13.73%、19.61%、31.37%、64.71%,均明显高于X线胸片的1.96%、5.88%、13.73%、7.84%,差异具有统计学意义(P<0.05)。结论 胸部MSCT定量及半定量指标可用于评估肺功能,在诊断粉尘作业引起的肺部弥漫性小结节方面具有较高的临床应用价值,且可用于追踪随访了解病情控制情况。Objective To study the diagnostic and follow-up value of multislice spiral CT(MSCT)for diffuse small pulmonary nodules caused by dust exposure.Methods 51 male dust workers diagnosed with stageⅠpneumoconiosis were selected as the pneumoconiosis group,and 51 male workers from the same period and factory building were selected as the dust exposure control group,and 51 healthy males from instrument and electromechanical factories in the same region were selected as the healthy control group.All subjects in the three groups were examined by chest X-ray and MSCT scan.MSCT quantitative and semi-quantitative indicators(lung volume,lung density and emphysema index),lung function indexes[forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and their ratio(FEV1/FVC)]in the three groups were compared,and the correlation between MSCT quantitative and semi-quantitative indicators and lung function indicators was analyzed.The results of chest X-ray and MSCT during follow-up were compared in pneumoconiosis group.Results The values of lung volume in healthy control group,dust exposure control group and pneumoconiosis group decreased successively,and the lung density and emphysema index increased successively,and the difference among the three groups was statistically significant(P<0.05).FVC,FEV1 and FEV1/FVC in healthy control group,dust exposure control group and pneumoconiosis group all showed a gradually decreasing trend,and there were statistically significant differences in each index among groups(P<0.05).There was no correlation between FVC and lung volume and lung density(P>0.05),but there was a negative correlation between FVC and emphysema index(r=-0.361,P<0.05).FEV1,FEV1/FVC were positively correlated with lung volume and lung density(r=0.472,0.574,0.548,0.709;P<0.05),and FEV1,FEV1/FVC were negatively correlated with emphysema index(r=-0.662, -0.739;P<0.05). At 2-year follow-up, the detection rate of small nodules, increased number of small nodules, perifocal emphysema, and calcified lymph nodes on M

关 键 词：多层螺旋CT 粉尘作业 肺部弥漫性小结节 诊断 追踪随访 

分 类 号：R135.2[医药卫生—劳动卫生]