摘要
目的探讨尘肺病小阴影密集度的CT分级方法,拟定相应的CT参考片。方法于2019年10月,收集安徽省铜陵市某大型铜业公司患者诊断资料,最终纳入337例尘肺病和可疑尘肺病病例。用GBZ 70-2015《职业性尘肺病的诊断》中相关指标判断胸片各肺区小阴影密集度。CT肺区小阴影密集度判断方法拟为0、0+、1、2、3共5级,其中0级相当于胸片0大级中的0/-、0/0小级,0+级相当于胸片0大级中的0/1小级,1、2、3级相当于胸片的1、2、3大级(含各小级)。CT肺区图像质量分为一至四级。评价各肺区图像质量;判断各肺区小阴影密集度,其中图像质量四级者不能判断小阴影密集度。对胸片和CT各肺区小阴影密集度结果进行一致性分析。制定CT小阴影密集度参考片的选取方法,选取不同类型小阴影及相应密集度的参考片。结果CT图像质量一至三级的肺区共1877个,其中右上、右中、右下、左上、左中、左下肺区分别为335、319、284、334、320、286个。CT和胸片小阴影密集度在右上、左上、左中和左下肺区的Kappa值为0.4~0.75,在右中和右下肺区的Kappa值均>0.75;CT与胸片各肺区的诊断符合率均>80%。分别拟出p、q型小阴影2级和3级密集度参考片,r型小阴影2级密集度参考片,s、t型小阴影0+~3级密集度参考片。结论尘肺病小阴影密集度CT分级方法可行,其参考片的应用价值有待进一步验证。
Objective To explore the CT grading method of small opacity profusion of pneumoconiosis,and draw up the corresponding CT reference film.Methods In December 2019,Three hundred thirty-seven cases of pneumoconosis and suspected pneumoconiosis were examined by chest radiography and Computed Tomography(CT)in the same period.According to Diagnosis of Occupational Pneumoconiosis(GBZ 70-2015),small opacity profusion of pneumoconiosis in each zone of lung was divided.On CT scans,it was divided into 5 grades of 0,0+,1,2 and 3.Grade 0 corresponded to Sub-grade 0/-and Sub-grade 0/0 of Grade 0 in chest radiograph.Grade 0+was equivalent to Sub-grade 0/1 of Grade 0.Grade 1,2,3 were equivalent to Grade 1,2 and 3,respectively(including each sub-grade).The CT image quality of each zone of lung was divided into 1 to 4 levels.Results of level 4 were not included in statistical analyses.Based on the results of small opacity profusion in each zone of lung,consistency analysis was performed between chest radiograph and CT.The selection method of reference films was developed.Based on the types and grades of small opacity,the final reference films were determined.Results There were 1877 zones of lung with CT image quality from level 1 to 3,including 335 in upper right,319 in middle right,284 in lower right,334 in upper left,320 in middle left and 286 in lower left.The Kappa values of small opacity profusion in upper right zone,upper left zone,left middle zone,and lower left zone were all between 0.4-0.75.In middle right zone and lower right zone,they were all above 0.75.Among all 6 zones of lung,the diagnostic concordance rates between CT and chest radiograph were all above 80%.The corresponding CT reference films were proposed,including type p and q in Grade 2 and 3,type r in Grade 2,type s and t in Grade 0+to 3.Conclusion The CT grading method for small opacity profusion of pneumoconiosis is feasible,and the application value of its reference films needs to be further verified.
作者
翟荣存
李年春
刘晓东
朱胜康
胡必锋
张爱农
童昕
汪国东
宛拥军
马芸
Zhai Rongcun;Li Nianchun;Liu Xiaodong;Zhu Shengkang;Hu Bifeng;Zhang Ainong;Tong Xin;Wang Guodong;Wan Yongjun;Ma Yun(Medical Imaging Center,Tongling Municipal Hospital,Tongling 244000,China;Tongling Municipal Hospital Shicheng Hospital,Tongling 244000,China)
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
北大核心
2021年第6期453-457,共5页
Chinese Journal of Industrial Hygiene and Occupational Diseases
基金
安徽省重点研究与开发计划项目(1804h08020238)。
