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目的探讨陶瓷企业接尘工人高千伏X射线胸片质量情况及其影响因素。方法随机选择1 110张陶瓷企业接尘工人高千伏X射线胸片作为质量分析资料,其中在放射科机房摄片530张(固定摄片组),车载摄片580张(车载摄片组)。由3名具有尘肺病诊断资质的医师集体读片,胸片质量分级按GBZ 70—2009《尘肺病诊断标准》附录C“胸片质量与质量评定”要求和分级标准进行评定。结果 1 110张高千伏X射线胸片优片、良片、差片和废片的比率分别为18.02%、27.75%、52.97%和1.26%。男性组优片率(22.33%)高于女性组(6.10%,P<0.001),女性组差片率(64.41%)高于男性组(48.83%,P<0.001),2组良片率和废片率比较,差异均无统计学意义(P>0.05)。固定摄片组优片率(25.28%)和差片率(56.23%)均高于车载摄片组(分别为11.38%和50.00%,P<0.05或P<0.001),良片率(17.74%)低于车载摄片组(36.90%,P<0.05)。影响差片质量的因素主要为心后影纹理难辨、胸片偏黑或偏白、肩胛骨未完全离开肺野、外来影、吸气不足和位置不正。外来影中女性文胸金属影发生率(80.53%)较高是影响胸片质量的主要因素。结论陶瓷接尘工人高千伏X射线胸片质量不高。胸片偏黑或偏白和/或外来影,尤其女性文胸金属影是造成高千伏X射线胸片质量下降的主要原因。
Objective To investigate the quality of high kilowatts X-ray chest radiograph for workers exposed to dust in ceramic enterprises and its influencing factors. Methods A total of 1101 high-kilowatt X-ray chest radiographs from dust collectors in ceramic enterprises were randomly selected. Among them, 530 radiographs (fixed radiographs), 580 car radiographs (car radiography) . By three physicians with pneumoconiosis diagnostic qualification collective reading, chest radiograph quality grading GBZ 70-2009 “pneumoconiosis diagnostic criteria” Appendix C “chest radiography quality and quality evaluation ” requirements and grading standards for evaluation. Results The ratio of good piece, good piece, poor piece and scrap piece of 110 high kV radiographs was 18.02%, 27.75%, 52.97% and 1.26% respectively. In the male group, the best film rate was higher (22.33%) than that of the female group (6.10%, P <0.001), the difference rate of the female group was 64.41% (48.83%, P <0.001) Waste scrap rate comparison, the difference was not statistically significant (P> 0.05). The rate of good film (25.28%) and poor film rate (56.23%) in fixed radiography group were higher than that in vehicle radiography group (11.38% and 50.00%, P <0.05 or P <0.001) ) Was lower than vehicle radiography group (36.90%, P <0.05). Affect the quality of the poor film quality mainly for the shadow of the heart shadow is difficult to distinguish, chest black or partial white, the scapula has not completely left the lung field, foreign film, inspiratory insufficiency and location is not correct. Foreign films female bra metal shadow incidence (80.53%) is a higher impact on the quality of the main factors. Conclusion Ceramic dust workers high kV X-ray chest is not high quality. Chest radiograph or partial white and / or foreign film, in particular, is the main cause of the quality degradation of high-kV X-ray film.