Martínez González C, Fernández Rego G, Jiménez Fernández-Blanco J R
Servicio de Medicina Preventiva, Diagnóstico y Valoración, Instituto Nacional de Silicosis, Hospital General de Asturias.
Arch Bronconeumol. 1997 Jan;33(1):12-5.
To assess the value of computed tomography (CT) scanning for the diagnosis of complicated pneumoconiosis, or progressive massive fibrosis (PMF), we conducted a prospective study of 127 subjects who had worked in coal mines for at least 15 years. Sixty-two suffered simple pneumoconiosis (nodular profusion > or = 1/1 under the ILO-80 international classification system) visible on simple chest films. None were diagnosed of PMF on the basis of X-ray evidence. CT led to a diagnosis of PMF in 8 cases (6.3%; CI 95%, 2.68-11.82). PMF was category A in all 8; all of them had had chest film evidence of simple pneumoconiosis. Six (75% of these patients had q and/or r nodulation; in 5 (62.5%) the nodules tended to confluence. These figures were significantly higher (p < 0.05, Fisher's test) than in the group of patients with no PMF, among whom 54 (45.3%) had SP, 2 (1.68%) had q and or r nodulation and 3 (2.52%) tended to confluence. We observed no differences in FVC, FEV1, the FEV1/FVC ratio or DLCO between the PMF and non PMF groups. Our results suggest that CT scans can be useful for diagnosing PMF in some cases in which it is suspected bases on chest X-ray findings (simple pneumoconiosis, q and/or r nodulation, tendency to confluence).
为评估计算机断层扫描（CT）对复杂尘肺病或进行性大块纤维化（PMF）的诊断价值，我们对127名在煤矿工作至少15年的受试者进行了一项前瞻性研究。62人患有单纯尘肺病（根据国际劳工组织80国际分类系统，结节密集度≥1/1），在普通胸片上可见。根据X线证据，无人被诊断为PMF。CT诊断出8例PMF（6.3%；95%置信区间，2.68 - 11.82）。所有8例PMF均为A类；他们所有人胸片上都有单纯尘肺病的证据。其中6例（这些患者的75%）有q和/或r结节；5例（62.5%）结节有融合倾向。这些数字显著高于（p < 0.05，Fisher检验）无PMF的患者组，该组中54例（45.3%）有单纯尘肺病，2例（1.68%）有q和/或r结节，3例（2.52%）有融合倾向。我们观察到PMF组和非PMF组在用力肺活量（FVC）、第一秒用力呼气容积（FEV1）、FEV1/FVC比值或一氧化碳弥散量（DLCO）方面无差异。我们的结果表明，对于根据胸部X线表现（单纯尘肺病、q和/或r结节、融合倾向）怀疑患有PMF的某些病例，CT扫描可能有助于诊断。
