目的 探讨胸部高分辨CT(HRCT)与高千伏X线胸片在诊断Ⅱ期矽肺中的价值,为提高矽肺诊断的准确率及病变的检出率提供影像学依据.资料与方法 对80例Ⅱ期矽肺患者的HRCT及高千伏X线胸片影像指标进行对比.结果 80例患者HRCT与高千伏X线胸片主要影像指标斑片条(x2=2.006,P= 0.157)、小阴影聚集(x2=1.607,P=1.205)和空洞(x2=2.939,P=0.086)差异无统计学意义,发白区(x2= 20.196,P=0.001)、大结节影(x2= 7.156,P= 0.007)、钙化(x2=4.113,P=0.043)、灶周气肿(x2= 7.629,P=0.006)、灶周结节(x2= 7.320,P=0.007)、纤维索条影(x2=10.620,P=0.001)、淋巴结肿大钙化(x2= 15.172,P=0.001)差异均有统计学意义;HRCT与高千伏x线胸片在不同级小阴影密集度的肺区数(x2= 115.08,P= 0.001)及矽肺分期(x2= 14.239,P= 0.001)差异有统计学意义；矽肺合并症:HRCT与高千伏X线胸片分别检出肺癌(15例对5例,x2= 5.714,P=0.017)差异有统计学意义,检出结核(36例对25例,x2= 3.206,P=0.073)、胸腔积液(18例对14例,x2=0.625,P=0.429)、气胸(12例对7例,x2=1.493,P=0.222)、胸膜肥厚钙化(22例对17例,x2= 0.848,P=0.357)差异无统计学意义.结论 HRCT与高千伏X线胸片在发白区、大结节影、钙化、灶周气肿、灶周结节、纤维索条影、淋巴结肿大钙化影像指标检出存在显著差异；在不同级小阴影密集度的肺区数及矽肺分期有显著差异;对矽肺合并症肺癌的诊断存在较大差异,二者在Ⅱ期矽肺的诊断中具有很强的互补性.%Purpose To explore the value of HRCT and high-kV X-ray in diagnosis of stage II silicosis. Materials and Methods HRCT and high-kV X-ray images from 80 cases with stage II silicosis were reviewed. Results Using x2 test, the detection rate of some imaging features suggesting stage II silicosis was not statistically different on HRCT and high-kV X-ray including patches and spots (f = 0.157), small shadows (.P = 1.205), and cavities (P = 0.086) while the detection rate of blanching area (P = 0.001), big nodules (P = 0.007), calcification (P = 0.043), focal emphysema (P = 0.006) and nodule (P = 0.007), fibrous changes (P = 0.001), lymph node enlargement and calcification (P = 0.001) was different. In silicosis staging and diagnosing the number of lung-zones with various grades of small shadow distribution, the difference between HRCT and high-kV X-ray was significant (P < 0.001). HRCT diagnosed more lung cancer (15cases vs. 5 cases) than high-kV X-ray. Other complications included tuberculosis (36 cases on HRCT vs. 25 cases on X-ray), pleural effusion (18 cases vs. 14 cases), pneumothorax (12 cases vs. 7 cases) showing no statistical difference (P>0.05). Conclusion HRCT and high-kV X-ray are complimentary in diagnosing silicosis.
展开▼
