华西医学

华西医学

煤工尘肺的薄层 16 层螺旋 CT 表现特征的优势分布及其病理基础

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目的 明确煤工尘肺的薄层 16 层螺旋 CT 表现特征、合并症在其分期及肺叶、肺野解剖中的优势分布。 方法 纳入 2014 年 10 月—2015 年 3 月经尘肺诊断鉴定组确诊的 66 例煤工尘肺患者,均行 16 层螺旋 CT 检查及层厚为 1.5 mm 的薄层 CT 重建。观察煤工尘肺的薄层 CT 征象和合并症,评价 CT 征象在分期及肺叶、肺野解剖中的优势分布。 结果 肺内不规则小结节为主 16 例,大阴影融合团 22 例,肺内阴影钙化 18 例,肺气肿 41 例,肺大疱、肺动脉高压各 21 例,纵隔内淋巴结增大/钙化 31 例,上述征象以 Ⅲ 期尘肺多见(P<0.05)。规则圆形小结节 32 例,以 Ⅰ 期尘肺多见。不规则小结节 16 例,优势分布于双肺野、肺叶的中、外带;大阴影融合团 22 例,优势分布于双肺上、下叶中带,以双肺上叶后部为主;肺结核 16 例,优势分布于双肺上叶;肺大疱 21 例,优势分布于双肺上叶外带,以右上肺居多。 结论 煤工尘肺的薄层 16 层螺旋 CT 征象能反映其病理变化,与尘肺分期存在一定的相关性,并在肺叶、肺野解剖分布上有明显特点。

Objective To clarify the thin-layer 16-slice spiral CT features of coal worker’s pneumoconiosis and the superior distribution of comorbidities in their staging and lobes and lung field anatomy. Methods Sixty-six patients with coal worker's pneumoconiosis diagnosed by the pneumoconiosis diagnosis and identification group from October 2014 to March 2015 were enrolled. All patients underwent 16-slice spiral CT and thin-layer CT reconstruction with a thickness of 1.5 mm. The thin-slice CT signs and comorbidities of coal workers’ pneumoconiosis were observed, and the superior distribution of CT signs in patients at different stage and different lobes and lung field anatomy were evaluated. Results There were 16 cases of irregular small nodules in the lungs, 22 cases of large shadow fusion, 18 cases of intraocular shadow calcification, 41 cases of emphysema, 21 cases of pulmonary bullae, 21 cases of pulmonary hypertension, and 31 cases of enlarged lymph nodes in the mediastinum and calcified. The above signs were mostly distributed in stage Ⅲ pneumoconiosis (P<0.05). There were 32 cases of regular small nodules, which were mostly distributed in stage Ⅰ pneumoconiosis. In the 16 cases of irregular small nodules, the advantage was distributed in the middle and outer lobes of the double lungs. In the 22 cases of large shadow fusion, the advantage was distributed in the upper and lower lobe of the lungs. In the 16 cases of tuberculosis, the advantage was distributed in the upper lobe of the lungs. In the 21 cases of bullous bullae, the advantage was distributed in the upper lobe of the two lungs, mostly in the right upper lung. Conclusion The thin 16-slice spiral CT signs of coal worker’s pneumoconiosis can reflect the pathological changes, and have a certain correlation with the stage of pneumoconiosis, and have obvious characteristics in the anatomical distribution of lung and lung fields.

关键词: 煤工尘肺; 体层摄影术,X 线计算机; 解剖; 病理

Key words: Coal worker’s pneumoconiosis; Tomography, X-ray computed; Anatomy; Pathology

引用本文: 温晓玲, 伍东升, 蔡舒, 杨玉翔, 李叶, 沈江. 煤工尘肺的薄层 16 层螺旋 CT 表现特征的优势分布及其病理基础. 华西医学, 2019, 34(1): 30-34. doi: 10.7507/1002-0179.201809058 复制

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