13例氧化铝尘肺X线分析

氧化铝广泛应用于炼铝，军工，航天，化工，轻工，石油，建材，机械，电子，医药等工业，随着工业飞速发展，接触氧化铝粉尘的工人日趋增多，为了澄清人们以往认为氧化铝粉尘不能致病的模糊概念，加强本病的防治工作，特将已定诊的13例氧化铝尘肺，就其X线形态改变结合动物实验分析报道如下。     

尘肺合并肺结核与单纯尘肺在CT影像学对比分析

目的 将尘肺合并肺结核与单纯尘肺的CT影像学特征进行对比分析,明确两者之间的差异。方法 收集2021年2月至2022年2月期间在赣州市第五人民医院确诊为尘肺合并肺结核和单纯尘肺患者各50例,回顾性分析比较两组的病变形态和病变范围。结果 与单纯尘肺组相比,尘肺合并肺结核组CT影像学检查中病变形态特征表现为斑片、索条、空洞、胸膜增厚、胸腔积液更为常见,而实变、合并支扩、合并气胸、纵隔淋巴增大伴/不伴钙化等影像学特征差异在2组间差异无统计学意义。尘肺合并肺结核组的病变的分布范围与单纯尘肺组相比更大。结论 尘肺合并尘肺与单纯尘肺的CT影像学检查显示,两组患者的病变形态存在一定的差异,尘肺合并尘肺患者肺部病变范围明显更大。     

尘肺X线摄片质量控制

肺部尘肺病X线照片质量直接影响到尘肺诊断的准确性，X线照片质量低劣会给国家和尘肺患者带来不利，进行X线胸部摄片质量保证(QA)和质量控制(QC)至关重要。     

尘肺的CT检查与X线胸片比较研究

目的对比分析胸部CT及X线胸片对尘肺的诊断价值。方法回顾性分析52例尘肺的胸部CT及X线胸片资料,男47例,女5例,平均年龄59岁。结果52例中有28例胸部CT表现有两肺弥漫性小阴影(直径<10mm的阴影),胸部X线发现19例有小阴影。大阴影(直径>10mm的阴影)CT显示13例,X线胸片显示9例。合并症CT显示20例,其中肺炎5例,肺结核3例,肺癌2例,气胸6例,肺气肿4例。X线胸片显示10例,其中肺炎1例,肺结核1例,气胸6例,肺气肿2例。结论在单纯的尘肺诊断中,CT并不优于X线胸片,但对大阴影、胸膜改变及合并症的检出率明显高于X线胸片,并可弥补X线胸片的不足。     

煤工尘肺HRCT的形态学表现及诊断价值研究

目的：探索煤工尘肺的ＨＲＣＴ特征。方法：１２４例煤工尘肺作肺部常规ＣＴ,然后在主动脉弓顶、隆突水平、气管分叉下３ｃｍ右膈上２ｃｍ及重点兴趣区加作ＨＲＣＴ,对其图像表现进行研究。结果：本组１２４例煤工尘肺ＨＲＣＴ清晰地显示了肺小叶间隔增厚、小叶核心改变及小叶间质增厚、尘肺结节、各型肺气肿和大阴影等病变的特征。结论：ＨＲＣＴ对显示煤工尘肺微细病变的多种形态学表现极有帮助,在鉴别诊断中亦具有重要价值     

石工尘肺胸部X线分析

石工尘肺是我区农民工的一种职业病，由于民工对尘肺的认识不足，常以临床症状或并发症而就诊。现将我中心1993年-2003年诊断的石工尘肺180例，收集资料较完整的80例（其中石工尘肺合并肺结核62例除外）胸片进行分析，以提高对本病的认识，结果报告如下。     

尘肺结节与周围型肺癌的X线诊断与鉴别

目的：探讨尘肺结节与周围型肺癌的X线表现及两者之间的区别与联系。材料与方法：对50例已被职业病鉴定中心确诊的尘肺患者和20例证实为周围型肺癌的患者，采用各自的分类、分期来比较两者之间的差另4与联系。结果：尘肺结节与周围型肺癌在X线征象上无显著差异。结论：通过对尘肺结节与周围型肺癌的分析、比较进一步认识到两者在X线片上无显著的特征性表现，X线诊断要依据职业史及相关的CT等检查。     

煤工尘肺的CT诊断

In order to evaluate the usefulness of CT in CWP, 100 coal workers were examined with both chest radiograph and CT scan. Comparison was done, the result indicated that both modalities yielded similar sensitivity to simple CWP. The CT score of simple CWP correlated well with ILO classification and 1986 Chinese criteria for staging of pneumoconiosis, whereas in complicated CWP, the CT scan was significantly superior to chest radiograph. CT scan identified readily large opacities. It could detect large opacities in 40% of simple CWP diagnosed on the basis of chest radiograph. CT scan also identified more cavities and calcifications within large opacities. The CT attenuation values were less reliable. The authors were of the opinion that at present CT attenuation values is not recommended for routine evaluation of CWP.     

尘肺影像诊断技术的研究进展

尘肺是由于长期吸入生产性粉尘导致的肺纤维化疾病,目前诊断主要依靠高千伏胸片.高千伏胸片具有清晰度高,成本低廉等优点;但也存在前后组织重叠,密度分辨率低等不足.近年,数字成像技术-CT、CR、DR发展迅速,成像速度快,密度分辨率高,图像后处理功能强等优点,尤其是多层螺旋CT,可以各向同性扫描,快速进行低失真冠、矢状面重建,兼有模拟成像和数字成像的双重优点.     

Complications of pneumoconiosis: Radiologic overview

A wide spectrum of pulmonary complications occurs in patients with pneumoconiosis. Those complications include chronic obstructive pulmonary disease, hemoptysis, pneumothorax, pleural disease, tuberculosis, autoimmune disease, anthracofibrosis, chronic interstitial pneumonia, and malignancy. Generally, imaging workup starts with plain chest radiography. However, sometimes, plain radiography has limited role in the diagnosis of pulmonary complications of pneumoconiosis because of overlapping pneumoconiotic infiltration. Computed tomography (CT), ultrasonography (US), and magnetic resonance imaging (MRI) are potentially helpful for the detection of pulmonary complications in patients with pneumoconiosis. CT, with its excellent contrast resolution, is more sensitive and specific method than plain radiograph in the evaluation of pulmonary abnormalities. CT is useful in detecting lung parenchymal abnormalities caused by infection, anthracofibrosis, and chronic interstitial pneumonia. Also, CT is valuable in distinguishing localized pneumothorax from bullae and aiding the identification of multiloculated effusions. US can be used in detection of complicated pleural effusions and guidance of the thoracentesis procedure. MRI is useful for differentiating between progressive massive fibrosis and lung cancer.     

Evaluation of pneumoconiosis by high-resolution CT]

Forty-eight patients with pneumoconiosis (47 males and 1 female) were evaluated by high-resolution computed tomography (HRCT), which was compared with chest radiography and pulmonary function studies. 1) HRCT was superior to chest radiography in detecting small nodular shadows. There was a good correlation between HRCT and chest radiography in evaluating nodule quantity and size. 2) HRCT was superior to chest radiography in detecting emphysematous changes, and the difference was significant. HRCT and chest radiography were closely correlated in their evaluation of the grade of emphysema. 3) The grade of emphysema on HRCT was negatively correlated with the number of nodules. Subpleural curvilinear shadow (SCLS) on HRCT was correlated with the grade of emphysema, but not with the number of nodules. 4) The comparison with pulmonary function studies showed that emphysematous change on HRCT alone was correlated with %DLCO, while SCLS was correlated with FEV1.0%, RV/TLC and %DLCO. HRCT of the lung is useful for complementing chest radiography and pulmonary function studies in the evaluation of pneumoconiosis.     

尘肺CT扫描方案的探讨

目的比较常规剂量CT、低剂量CT及高分辨率CT（HRCT）3种扫描方案对尘肺的诊断能力,以期确定最佳方案。方法 37例经专业机构确诊的尘肺患者均经常规剂量CT、低剂量CT及HRCT3种方案扫描。采用统计学方法分析与比较该3种方案对尘肺特征性表现,小阴影、大阴影及进行性团块状纤维化（PMF）及纤维化早期表现及合并症的检出率。结果 3种扫描方案对小阴影、大阴影及团块状纤维化（PMF）的检出例数相符,均为36例、20例及16例,而对于大、小阴影及PMF周围的瘢痕肺气肿、肺纹理扭曲等征象,以HRCT显示较清晰。HRCT对早期肺间质纤维化,诸如胸膜改变、小叶间隔增厚、小叶肺气肿及蜂窝状影的显示例数显著多于其他两组（P〈0.05）。除肺气肿外,3种方案对其他合并症肺结核、肺癌及呼吸系统感染等的检出率无明显差别。结论低剂量CT与常规剂量CT均可用于尘肺的普查与诊断,为减少受检者的辐射剂量,应尽可能采用低剂量CT扫描。而对于肺间质改变的观察,HRCT应作为首选方案。