尘肺病胸部CT不规则小阴影关联影像密集度评价方法  

The profusion evaluation method for irregular small opacities associated with pneumoconiosis in chest CT

作　　者：王强 白净 葛路岩 张宁宁[3] 张利静 康非 董会台 WANG Qiang;BAI Jing;GE Luyan;ZHANG Ningning;ZHANG Lijing;KANG Fei;DONG Huitai(Shijiazhuang Maternity&Child Healthcare Hospital,Shijiazhuang,Hebei 050090,China;不详)

机构地区：[1]石家庄市妇幼保健院,河北石家庄050090 [2]石家庄市疾病预防控制中心,河北石家庄050011 [3]中国医学科学院,北京100005

出　　处：《中国职业医学》2024年第6期650-655,共6页China Occupational Medicine

基　　金：2022年度河北省医学科学研究课题计划(20221658)。

摘　　要：目的探讨职业性尘肺病患者胸部计算机断层扫描(CT)不规则小阴影关联影像密集度评价方法。方法回顾性收集20例数字化X射线摄影(DR)胸片以不规则小阴影为主要表现的职业性尘肺病患者为研究对象。通过对比DR胸片与5 mm胸部CT冠状位多平面重建图像(MPR)的异常影像,分析不规则小阴影成因。采用加权优劣解距离法结合层次分析法(TOPSIS-AHP)建立胸部CT不规则小阴影关联影像密集度评价方法,比较其与GBZ 70—2015《职业性尘肺病的诊断》的密集度判定结果。结果20例研究对象5 mm胸部CT冠状位MPR异常影像分布为:高密度圆形小阴影3例,低密度圆形小阴影7例;弥漫性低密度磨玻璃影(GGO)6例;网状阴影4例;片状GGO 3例,蜂窝影3例;肺纹理增多4例。异常影像CT值由高到低依次为:蜂窝影>片状GGO>低密度圆形小阴影>弥漫性低密度GGO(P值均<0.05)。一致性检验结果显示,胸部CT不规则小阴影关联影像密集度评价方法与GBZ 70—2015《职业性尘肺病的诊断》密集度判定结果具有高度一致性(Kappa=0.78)。结论职业性尘肺病患者胸部DR不规则小阴影是由多种异常肺纤维化影像叠加形成。TOPSIS-AHP可用于建立胸部CT不规则小阴影关联影像密集度评价方法。Objective To explore a method for assessing the irregular small opacities profusion associated with occupational pneumoconiosis in chest computed tomography(CT).Methods A total of 20 occupational pneumoconiosis patients whose primary manifestation was irregular small opacities on chest digital radiography(DR)were collected as the research subjects using a retrospective study method.Comparative analysis was performed between chest DR and five mm coronal multi-planar reconstruction(MPR)of chest CT images to identify the causes of irregular small opacities.An evaluation method for the profusion of associated images of irregular small opacities in chest CT was established using technique for order preference by similarity to ideal solution-analytic hierarchy process(TOPSIS-AHP),and the results were compared against GBZ 70-2015 Diagnosis of Occupational Pneumoconiosis.Results The abnormal image distribution on the five mm coronal chest CT MPR images of the 20 patients was as follows:three cases of high-density small circular opacities,seven cases of low-density circular small opacities,six cases of diffuse low-density ground-glass opacities(GGO),four cases of reticular opacities,three cases of plate-like GGO,three cases of honeycomb opacities,and four cases of increasing lung texture.The CT values of abnormal images,from high to low were:honeycomb opacities>plate-like GGO>low-density circular small opacities>diffuse low-density GGO(all P<0.05).The consistency test results indicated that the evaluation method for the profusion of associated images of irregular small opacities in chest CT showed high level of agreement with the profusion determination criteria outlined in GBZ 70-2015 Diagnosis of Occupational Pneumoconiosis(Kappa=0.78).Conclusion Irregular small opacities observed on chest DR are formed by the superposition of multiple images of abnormal pulmonary fibrosis in patients with occupational pneumoconiosis.TOPSIS-AHP can be used to establish an evaluation method of the profusion of associated image of irregul

关 键 词：尘肺病 不规则小阴影 数字化X射线摄影 计算机断层扫描 密集度 

分 类 号：R135.2[医药卫生—劳动卫生]