采用数字化与高千伏X线胸片进行矽肺诊断的对照研究

来源 :中华劳动卫生职业病杂志 | 被引量 : 0次 | 上传用户:o9876521
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目的:通过观察胸部数字化X线摄影软拷贝图像(copy image of chest digital radiography,DRn SC)的读片效果,并与胶片-增感屏高千伏X线胸片(high kV film-screen chest radiography,FSRn HkV)对照分析,探讨尘肺诊断DRn SC读片的可行性,为建立尘肺诊断的区域信息网络平台提供依据。n 方法:2019年6月,收集2017年10月至2019年8月云南省第三人民医院收治的从事铜矿或铅锌矿开采并接触矽尘的119名矿工作为调查对象。由三名有经验的诊断医师各自独立对每个病例的DRn SC和FSRHn kV胸部X线表现分别作出判定和诊断,以多数医师认同的判定和诊断作为最终判定结果。以肺部主要小阴影形态、总体密集度、分布范围、小阴影集聚和大阴影,以及诊断分期为观察指标,分析两种成像方式一致性。n 结果:调查对象中男性118例,女性1例,平均年龄46.21岁。平均接尘时间7.38年。113例两种成像方式的肺部X线表现以p、q、r圆形小阴影为主,网状不规则影不明显,仅观察到1例FSRn HkV判定p影DRn SC判定q影,两者符合率99.12%(112/113)。另外6例均观察到巨大阴影。无尘肺和壹期判定符合率为95.51%(4/89);贰期和叁期判定均未出现差异(30/30),无统计学意义(n P>0.05)。n 结论:以肺部圆形小阴影为主的矽肺X线表现,DRn SC可以用于诊断分期读片。n “,”Objective:To explore the feasibility of soft copy image of chest digital radiography (DRn SC) in pneumoconiosis diagnosis by observing the reading effect of DRn SC and comparing it with high kV film-screen chest radiography (FSRn HkV) . To provide a basis for the establishment of a regional information network platform for pneumoconiosis diagnosis.n Methods:A total of 119 miners who were exposed to silica dust and engaged in copper or lead-zinc mining were collected by the Third People's Hospital of Yunnan from October 2017 to August 2019. The pulmonary X-ray findings of DRSC and FSRn HkV in each case were independently judged and diagnosed by three experienced diagnostic physicians, and the final decision was made according to the consensus of most doctors. The consistency of the two imaging methods was analyzed by observing the main small opacity shape, the overall density, the range of distribution, the aggregation of the small opacity and the big opacity, and the diagnosis stage.n Results:there were 118 males and 1 female with an average age of 46.21 years. Average exposure time 7.38 years. The pulmonary X-ray findings of 113 cases with two imaging methods were mainly the round small opacity of p,q and r,but the reticular irregular opacity were not prominent, Only one case of FSRn HkV judgment p shape and DRn SC judgment q shape were observed, The coincidence rate was 99.12% (112/113) . huger opacity were observed in the other 6 cases. The coincidence rate was 95.51% (4/89) between pneumoconiosis-free and stageⅠ, and there was no significant difference between stageⅡand stage Ⅲ (30/30, n P>0.05) .n Conclusion:The x-ray findings of Silicosis with small round shadow in lung can be used by DRn SC in diagnosis and staging.n
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