Ruckley V A, Fernie J M, Chapman J S, Collings P, Davis J M, Douglas A N, Lamb D, Seaton A
Br J Ind Med. 1984 Nov;41(4):459-67. doi: 10.1136/oem.41.4.459.
The pathology and dust content of lungs from 261 coalminers in relation to the appearances of their chest radiographs taken within four years of death were examined. Radiological opacities of coalworkers' pneumoconiosis were more profuse the more dust was retained in lungs. Among the men who had mined low rank coal--that is, with a relatively high proportion of ash--the increase in profusion was most closely related to the ash component of the dust, whereas in men who had mined high rank coal both coal and ash increased in the lungs in relation to radiological profusion. The fine p type of opacity was found to be associated with more dust and a higher proportion of coal and less ash than the nodular r opacity, and was also more likely to be associated with emphysema. The pathological basis of the different types of opacity found on the radiographs of coalminers related to the number, size, and nodularity of the dust lesions. Larger fibrotic lesions were likely to appear as r opacities, whereas fine reticular dust deposition was most likely to present as p opacities, q opacities showing a mixture of appearances. The study has shown that the composition of dust retained in the lung, as well as its amount, makes an important contribution to the radiographic appearances of pneumoconiosis. In particular, the r type of lesion on the radiograph of a low rank coalminer indicates the possibility of a silicotic like lesion.
对261名煤矿工人死亡后四年内拍摄的胸部X光片与其肺部病理及粉尘含量进行了检查。煤工尘肺的放射学阴影越多，肺内滞留的粉尘就越多。在开采低阶煤（即灰分比例相对较高）的工人中，阴影增多与粉尘中的灰分成分关系最为密切，而在开采高阶煤的工人中，肺内煤和灰分的增加都与放射学阴影增多有关。发现细颗粒状p型阴影比结节状r型阴影与更多的粉尘、更高的煤比例和更低的灰分相关，并且也更可能与肺气肿有关。煤矿工人X光片上发现的不同类型阴影的病理基础与粉尘病变的数量、大小和结节性有关。较大的纤维化病变可能表现为r型阴影，而细网状粉尘沉积最可能表现为p型阴影，q型阴影则呈现出混合表现。该研究表明，肺内滞留粉尘的成分及其数量对尘肺的放射学表现有重要影响。特别是，低阶煤矿工人X光片上的r型病变表明可能存在类似矽肺的病变。
