高分辨率CT对焊工肺尘埃沉着病的诊断价值

目的 采用高分辨率CT(HRCT)探讨早期焊工肺尘埃沉着病的影像表现,并评估不同病程阶段的影像表现.方法 对76例X线胸片疑似焊工肺尘埃沉着病的工人(工龄1～18年,平均14年)进行常规胸部CT平扫和HRCT检查,分析其HRCT表现,并对不同影像表现的年龄、工龄进行t检验.结果 18例(18/76,23.7%)表现为边缘模糊的小叶中央磨玻璃密度微结节,20例(20/76,26.3%)表现为分支状细线影,磨玻璃密度结节组的平均年龄[(34±7)岁]小于分支状细线影组[(39±9)岁],但差异无统计学意义(t=-1.648,P＞0.05);磨玻璃密度结节组的平均工龄[(10±5)年]低于分支状细线影组[(15±8)年],差异有统计学意义(t=-2.108,P＜0.05).结论 边缘模糊的小叶中央磨玻璃密度微结节和分支状细线影是焊工肺尘埃沉着病常见的表现.其中磨玻璃密度的微结节可能是焊工肺尘埃沉着病的早期表现.HRCT有助于焊工肺尘埃沉着病的早期诊断.

High-resolution CT in the evaluation of pneumoconiosis in welders

Objective To describe the high-resolution CT(HRCT)findings of arc-welders with early pneumoconiosis and to evaluate manifestation in different course of disease.Methods Seventy-six arc-welders with a one to thirty-eight(mean,14)years history of exposure underwent CT and HRCT scanning.The extent of abnormalities were detected.The relations of age and year history of exposure were analysed in different groups.Results Thirty-eight welders(38/76,50%)showed positive characteristic findings with conventional CT.Predominant thin-section CT findings were poorly-defined centrilobular micronodules(18/76,23.7%),branching linear structure(20/76,26.3%).The mean age in group of branching linear structure[(39±9)years old]was elder than of poorly-defined centrilobular micronodules[(34±7)years old].There was no statistical difference between the two groups(t=-1.648,P＞0.05).The mean length of service at exposure in group of branching linear structure[(15±8)years]was longer than of poorlydefined centrilobular micronodules[(10±5)years].And the significant differences were showed between the two groups in the year history of exposure(t=-2.108,P＜0.05).Conclusions Poorly defined centrilobular micronodules and branching linear structures were the thin-section CT findings most frequently seen in patients with arc-welders'pneumoconiosis and the former may be one early stage characteristic finding of arc-welders'pneumoconiosis.HRCT is useful in achieving more accurate categorization of the parenchymal changes in arc-welders'pneumoconiosis.