Liu Pei-cheng, Su Han-xin, Ai Xue-ru, Wu Chun, Zhang Dun, Chen Jing-bo, Cai Gui-ping
Medical Imaging Department, Xinjiang Coal Miner General Hospital, Urumqi 830091, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2004 Feb;22(1):39-42.
To analyse CT and high resolution computerized tomography (HRCT) diagnostic value and morphologic manifestation in coal miner's pneumoconiosis with pleural pathological changes.
One hundred and thirty-one cases of coal miner patients with pneumoconiosis (0(+) type: 14 cases, type I: 46 cases, type II: 58 cases, type III: 13 cases) and 20 normal people as control group were first examined by routine CT scan at 4 fixed slices, followed by HRCT examination at the region of interest (ROI). Meanwhile, all of them had high-kV chest radiography.
According to the national standard of the People's Republic of China in the diagnosis of coal miner's pneumoconiosis with pleural plaque, 68 cases of pleural disease making up 51.91% (68/131) were found (type I accounted for 17.65%, type II 63.24%, type III 19.12%). The morphologic manifestation of pleural pathology by HRCT could be classified into four types: (1) nodular type: 73.38%, (2) flat type: 18.71%, (3) irregular type: 7.91%, (4) mixed type. The pleural pathological changes were found in thoracic wall pleura (65.02%), surface of mediastinum (22.16%), and pericardium (12.80%), but not found in the top of lung and costo-phrenic angles. The thickness of pleura was often about 5 approximately 10 mm (88.17%).
Pleural pathological changes were not seldom seen in coal miner's pneumoconiosis. HRCT is a reliable examination method aiding routine CT to show pleural pathological changes, thus it has a great diagnostic and practical value. It is necessary to make a further comparison study between pathology and imagology.
分析CT及高分辨率计算机断层扫描(HRCT)对合并胸膜病变的煤矿工人尘肺的诊断价值及形态学表现。
选取131例煤矿工人尘肺患者(0(+)期:14例,Ⅰ期:46例,Ⅱ期:58例,Ⅲ期:13例),以20名正常人为对照组,先进行常规CT扫描4个固定层面,然后对感兴趣区(ROI)行HRCT检查。同时,所有患者均进行高千伏胸部X线摄影。
按照中华人民共和国国家标准诊断合并胸膜斑的煤矿工人尘肺,发现68例胸膜病变,占51.91%(68/131)(Ⅰ期占17.65%,Ⅱ期占63.24%,Ⅲ期占19.12%)。HRCT显示的胸膜病变形态学表现可分为4种类型:(1)结节型:73.38%,(2)扁平型:18.71%,(3)不规则型:7.91%,(4)混合型。胸膜病变见于胸壁胸膜(65.02%)、纵隔面(22.16%)和心包(12.80%),肺尖和肋膈角未见。胸膜厚度多约5~10mm(88.17%)。
煤矿工人尘肺中胸膜病变并不少见。HRCT是协助常规CT显示胸膜病变的可靠检查方法,具有较大的诊断及实用价值。有必要进一步进行病理学与影像学的对比研究。