Gevenois P A, Pichot E, Dargent F, Dedeire S, Vande Weyer R, De Vuyst P
Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Belgium.
Acta Radiol. 1994 Jul;35(4):351-6.
We compared CT with chest radiography (CR) in the assessment of low grade coal worker's pneumoconiosis (CWP) in a population of 83 subjects. All subjects had a high-voltage p.a. CR, graded according to the ILO classification between 0/0 and 1/1, a conventional CT (CCT) using contiguous 1-cm-thick sections on the entire thorax and a set of 10 high-resolution CT (HRCT) images. CR and CT were separately read by consensus by 2 teams of 2 trained readers. CR was coded 0/0 in 9 subjects; 0/1 in 31; 1/0 in 28; 1/1 in 15. Among these groups of patients, micronodules were detected by CT in respectively 2 (22%), 14 (45%), 17 (61%) and 10 (67%) patients. In all groups, micronodules were more often detected by CT when the opacities detected on CR were scored as rounded (p, q) than irregular (s, t). Among the patients graded 0/0 or 0/1, CT showed micronodules in 40%. By contrast, among the patients graded 1/0 or 1/1, CT did not show micronodules in 37%, but revealed in numerous patients that opacities detected on CR were related to bronchiectasis and/or emphysema only. Comparative analysis of HRCT and CCT showed that both techniques are complementary and proved the usefulness of CCT in the detection or confirmation of low profusion of micronodules.
我们对83名受试者进行了研究，比较了CT与胸部X线摄影（CR）在评估轻度煤工尘肺（CWP）中的作用。所有受试者均接受了高电压后前位CR检查，根据国际劳工组织（ILO）分类标准，其结果在0/0至1/1之间；进行了常规CT（CCT）检查，扫描整个胸部，层厚1 cm；还获取了一组10张高分辨率CT（HRCT）图像。由两组各两名经过培训的阅片者分别对CR和CT图像进行会诊判读。CR检查结果为0/0的有9名受试者；0/1的有31名；1/0的有28名；1/1的有15名。在这些患者组中，CT分别在2名（22%）、14名（45%）、17名（61%）和10名（67%）患者中检测到微小结节。在所有组中，当CR上检测到的不透明影被判定为圆形（p、q）时，CT更常检测到微小结节，而不规则形（s、t）则不然。在分级为0/0或0/1的患者中，CT显示微小结节的比例为40%。相比之下，在分级为1/0或1/1的患者中，CT在37%的患者中未显示微小结节，但在许多患者中发现CR上检测到的不透明影仅与支气管扩张和/或肺气肿有关。HRCT和CCT的对比分析表明，这两种技术具有互补性，且证明了CCT在检测或确认微小结节低密集度方面的有用性。
