诊断尘肺病胸部CT后处理图像适宜性分析  

Study on suitability of chest CT post-processing images for diagnosis of pneumoconiosis

作　　者：刘畅 杨明 王强 白净 张宁宁 段铮 董会台 LIU Chang;YANG Ming;WANG Qiang;BAI Jing;ZHANG Ningning;DUAN Zheng;DONG Huitai(Department of Infection Management,Fuyu Hospital of Traditional Chinese Medicine,Songyuan 131200,China;Department of Radiology,The Fifth Hospital of Shijiazhuang,Shijiazhuang 050019,China;Department of Radiology,Shijiazhuang Maternal and Child Health Hospital,Shijiazhuang 050090,China;Department of Occupational Health,Shijiazhuang Center for Disease Control and Prevention,Shijiazhuang 050011,China;Institute of Basic Medicine,Chinese Academy of Medical Sciences,Beijing 100005,China)

机构地区：[1]吉林省扶余市中医院感染管理科,吉林松原131200 [2]河北省石家庄市第五医院放射科,河北石家庄050019 [3]河北省石家庄市妇幼保健院放射科,河北石家庄050090 [4]河北省石家庄市疾病预防控制中心职业卫生科,河北石家庄050011 [5]中国医学科学院基础医学研究所,北京100005

出　　处：《医学影像学杂志》2025年第2期39-42,47,共5页Journal of Medical Imaging

基　　金：河北省医学科学研究课题计划项目(编号:20221658)。

摘　　要：目的探讨遴选适宜尘肺病诊断的胸部CT图像模式。方法选取74例(以圆形小阴影为主要表现的67例,以不规则小阴影为主要表现的6例,石棉肺1例)行DR和MSCT检查的尘肺病患者影像资料,对1.5 mm和5.0 mm轴位重建CT图像、1.0 mm和5.0 mm冠状位MPR图像和5.0 mm冠状位MIP图像以及DR图像进行比较和分析。结果5种胸部CT模式中,5.0 mm胸部CT冠状位MPR图像更具优势;5.0 mm冠状位MPR图像与DR图像圆形小阴影大小、总体密集度差异无统计学意义(P>0.05),一致性检验Kappa值分别为0.70、0.64,一致性一般;B类大阴影检出率差异无统计学意义(P>0.05),一致性检验Kappa值为0.92,一致性较好。结论5.0 mm冠状位MPR图像作为尘肺病诊断的胸部CT图像是适宜的、可行的,GBZ70-2015不能直接用于胸部CT圆形小阴影密集度的判定。Objective To select the chest CT image pattern suitable for the diagnosis of pneumoconiosis.Methods 74 cases of pneumoconiosis with DR and MSCT data(67 cases with small circular shadow and 6 cases with small irregular shadow)were selected as research objects.The 1.5 mm and 5.0 mm axial reconstructed CT images,1.0 mm and 5.0 mm coronal MPR images,5.0 mm coronal MIP images,and DR images were compared and analyzed.Results Among the 5 chest CT modes,the coronal MPR image of 5.0 mm chest CT was more advantageous.There was no statistical significance in the size and profusion of small circular shadow between 5.0 mm coronal MPR image and DR image(P>0.05),and the Kappa values of consistency test were 0.70 and 0.64,respectively,showing general consistency.There was no significant difference in the detection rate of Class B large shadow(P>0.05),and the Kappa value of consistency test was 0.92,indicating a good consistency.Conclusion 5.0 mm coronal MPR image is suitable and feasible as chest CT image for diagnosis of pneumoconiosis.GBZ70-2015 can not be directly used to determine the degree of small circular shadow set in chest CT.

关 键 词：尘肺病 圆形小阴影 密集度 数字X线摄影术 体层摄影术 X线计算机 

分 类 号：R135.2[医药卫生—劳动卫生] R814.42[医药卫生—公共卫生与预防医学]