煤工尘肺患者多层螺旋计算机体层成像影像特征  

Multi-slice spiral computerized tomography image characteristics of coal workers with pneumoconiosis

作　　者：李欣宇 李宝平 沈福海 孙治平 侯博文 高丽妮 李倩倩 刘晓璐 马超逸 LI Xinyu;LI Baoping;SHEN Fuhai;SUN Zhiping;HOU Bowen;GAO Lini;LI Qianqian;LIU Xiaolu;MA Chaoyi(School of Public Health,North China University of Technology,Tangshan,Hebei 063210,Chin;Hebei Key Laboratory of Occupational Health and Safety for Coal Industry,North China University of Technology,Tangshan,Hebei 063210,China;Occupational Disease Department,Emergency General Hospital,Beijing 100028,China;Key Laboratory of Pneumoconiosis of National Health Commission,The First Hospital of Shanxi Medical University,Taiyuan,Shanxi 030001,China)

机构地区：[1]华北理工大学公共卫生学院,河北唐山063210 [2]华北理工大学河北省煤矿卫生与安全重点实验室,河北唐山063210 [3]应急总医院职业病科,北京100028 [4]山西医科大学第一医院国家卫生健康委员会尘肺病重点实验室,山西太原030001

出　　处：《环境与职业医学》2024年第7期774-779,共6页Journal of Environmental and Occupational Medicine

基　　金：国家卫生健康委员会尘肺病重点实验室开放课题基金资助项目(NHC202305)。

摘　　要：[背景]多层螺旋计算机体层成像(MSCT)诊断尘肺时可作为胸片的辅助诊断,但目前已有的文献中少有煤工尘肺肺间质影像与期别间相关性的研究。[目的]探讨煤工尘肺及并发症的MSCT影像学表现及其分布特征,分析煤工尘肺期别与肺间质病变的相关性,为尘肺肺间质病变提供可靠的影像诊断依据。[方法]本研究对象来自2022年6月—2023年6月于应急总医院职业病科筛选经尘肺诊断鉴定组确诊的1002例煤工尘肺患者。应用MSCT检查,观察煤工尘肺患者肺部各种异常的影像学表现以及与自身疾病有关的肺纤维化本质的疾病(小叶间隔增厚、支气管血管周围间质增厚、肺实质带状影,胸膜下线、小叶内间质增厚、蜂窝、胸膜下间质增厚)、煤工尘肺及并发症的发生情况(陈旧性肺结核、活动性肺结核、肺炎、肺不张、肺癌、支气管扩张)以及尘肺结节的密度、大小以及位置的分布,对影像学资料进行分析及统计学处理。[结果]本次研究中1002患者均为男性,平均年龄(60.71±6.87)岁,平均接尘时间(23.01±7.80)年。其中壹期患者470例,贰期患者422例,叁期患者110例。小叶间隔增厚、支气管血管周围间质增厚、肺实质带状影、小叶内间质增厚、胸膜下间质增厚、蜂窝在不同期别的分布上差异有统计学意义(P<0.05)。圆形小阴影p、q、r型在不同期别尘肺患者中差异均有统计学意义(P<0.05)。结节类型包括实性结节、纯磨玻璃影结节和部分实性结节。肺结核、支气管扩张在不同期别的分布上差异有统计学意义(P<0.05)。在尘肺合并肺炎的分型中间质影和斑片合并间质影在不同期别的分布上差异有统计学意义(P<0.05)。[结论]MSCT影像表现可以反映煤工尘肺病情变化进展,并与煤工尘肺的期别有一定的关系,有利于临床早期制定合理的治疗方案。因此,在尘肺病诊断和治疗中,应重视胸部计算机体层成[Background]Multi-slice spiral computerized tomography(MSCT)can be used as an auxiliary diagnosis of chest radiography in diagnosis of pneumoconiosis,but there are few studies on the correlations between interstitial images and stage classification of coal workers'pneumoconiosis in the existing literature.[Objective]To present MSCT imaging manifestations and distribution characteristics of coal workers'pneumoconiosis and complications,evaluate correlations between coal workers'pneumoconiosis stages and pulmonary interstitial lesions,and provide a reliable imaging diagnosis basis for pneumoconiosis interstitial lesions.[Methods]From June 2022 to June 2023,a total of 1002 patients with coal workers'pneumoconiosis confirmed by the pneumoconiosis diagnostic and identification group in the Department of Occupational Diseases of the Emergency General Hospital were enrolled.MSCT was used to observe the abnormal imaging manifestations of the lungs of coal workers'pneumoconiosis patients and the diseases of pulmonary fibrosis related to their own diseases(thickening of the interlobular septum,bronchial perivascular interstitial mass thickening,parenchymal banding,subpleural line,intralobular interstitial thickening,honeycomb,and subpleural interstitial thickening),the occurrence of coal workers'pneumoconiosis and complications(old tuberculosis,active tuberculosis,pneumonia,atelectasis,lung cancer,bronchiectasis),and the density,size,and location of pneumoconiosis nodules.Imaging data were analyzed and statistically processed.[Results]All 1002 patients were male,with an average age of(60.71±6.87)years and an average dust exposure time of(23.01±7.80)years.Among them,there were 470 patients with stage I,422 patients with stage II,and 110 patients with stage III.There were significant differences in the distribution of thickening of the interlobular septum,bronchial perivascular interstitial mass thickening,parenchymal banding,intralobular interstitial thickening,subpleural interstitial thickening,and honeycomb across diffe

关 键 词：煤工尘肺 多层螺旋计算机体层成像 肺间质病变 小阴影 影像学特点 

分 类 号：R135.2[医药卫生—劳动卫生]