Department of Radiology, Isahaya General Hospital, Nagasaki, Japan.
Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Acta Radiol. 2022 Jul;63(7):909-913. doi: 10.1177/02841851211022501. Epub 2021 Jun 7.
Chest radiography (CR) is employed as the evaluation of pneumoconiosis; however, we sometimes encounter cases in which computed tomography (CT) is more effective in detecting subtle pathological changes or cases in which CR yields false-positive results.
To compare CR to CT in the diagnosis of early-stage pneumoconiosis.
CR and CT were performed for 132 workers with an occupational history of mining. We excluded 23 cases of arc-welder's lung. Five readers who were experienced chest radiologists or pulmonologists independently graded the pulmonary small opacities on CR of the remaining 109 cases. We then excluded 37 cases in which the CT data were not sufficient for grading. CT images of the remaining 72 cases were graded by the five readers. We also assessed the degree of pulmonary emphysema in those cases.
The grade of profusion on CR (CR score) of all five readers was identical in only 5 of 109 cases (4.6%). The CR score coincided with that on CT in 40 of 72 cases (56%). The CT score was higher than that on CR in 13 cases (18%). On the other hand, the CT score was lower than that on CR in 19 cases (26%). The incidence of pulmonary emphysema was significantly higher in patients whose CR score was higher than their CT score.
CT is more sensitive than CR in the evaluation of early-stage pneumoconiosis. In cases with emphysema, the CR score tends to be higher in comparison to that on CT.
胸部 X 射线摄影（CR）被用于尘肺病的评估；然而，我们有时会遇到 CT 更有效地检测细微病理变化的情况，或者 CR 产生假阳性结果的情况。
比较 CR 和 CT 在早期尘肺病诊断中的应用。
对 132 名有采矿职业史的工人进行 CR 和 CT 检查。排除 23 例电弧焊工肺。5 位有经验的胸部放射科医生或肺病学家对其余 109 例 CR 的肺部小结节进行独立分级。然后排除 37 例 CT 数据不足的病例。对其余 72 例 CT 图像由 5 位读者进行分级。我们还评估了这些病例的肺气肿程度。
所有 5 位读者对 CR 的弥漫度评分（CR 评分）完全一致的病例仅为 109 例中的 5 例（4.6%）。CR 评分与 72 例中的 40 例 CT 评分相符（56%）。CT 评分高于 CR 评分的有 13 例（18%）。另一方面，CT 评分低于 CR 评分的有 19 例（26%）。CR 评分高于 CT 评分的患者中，肺气肿的发生率明显更高。
CT 比 CR 更敏感，在评估早期尘肺病方面更有效。在肺气肿患者中，CR 评分往往高于 CT 评分。
