SCT结合HRCT在煤工尘肺诊断中应用价值研究.docVIP

精品论文 参考文献 SCT结合HRCT在煤工尘肺诊断中应用价值研究 陈自强 姚玉龙（安徽淮北矿业集团职业病防治院 安徽淮北 235000） 【中图分类号】R521【文献标识码】A【文章编号】1672-5085（2011）40-0031-02 【摘要】目的 观察煤工尘肺在SCT及HRCT的表现，探讨两者的结合应用对提高煤工尘肺诊断的价值。方法 已明确诊断煤工尘肺患者82例全部行全肺SCT扫描，然后在主动脉弓顶、气管隆凸、气管分叉下3 cm、右膈上2 cm重点兴趣区行HRCT检查。观察和比较煤工尘肺在SCT与HRCT的表现。结果 本组82例患者SCT与HRCT能很好显示煤工尘肺结节、大阴影、肺门及纵隔淋巴结增大、肺气肿及合并症；HRCT能清晰显示煤工尘肺结节、肺小叶间隔增厚、各型肺气肿和大阴影等病变的特征。结论 SCT结合HRCT有利于煤工尘肺的诊断与鉴别诊断。 【关键词】煤工尘肺 SCT HRCT Application of SCT in Combination with HRCT in Diagnosis of Coal Labor Pneumoconiosis 【Abstract】 Objective To observe the appearance of pneumoconiosis on SCT and HRCT,to investigate the value of SCT in Combination with HRCT was helpful in diagnosis of Coal Labor pneumoconiosis. Methods 25 cases of Coal Labor pneumoconiosis were examined with SCT at first ,then followed with HRCT examination at top of aortic arch,carina of trachea,3cm below the bifurcation of bronchi and 2cm above the right diaphragm as well as other interesting areas.The features were studied and compared on SCT and HRCT.Results The features including nodule,large shadows,the hilar and mediastinal enlarged lymph,pulmonary emphysema and complication were clearly demonstrated on SCT and HRCT. But on HRCT the features including nodule, thicking of interlobular septal,pulmonary emphysema and large shadows were more clearly demonstrated in 25 cases. Conclusion SCT in Combination with HRCT scan was helpful in diagnosis of Coal Labor pneumoconiosis. 【Key words】Coal Labor Pneumoconiosis SCT HRCT 煤工尘肺是是煤矿工人吸入矽尘和煤尘所致的以肺部弥漫性纤维性病变为主的尘肺。诊断主要根据可靠的煤尘接触史及高千伏X射线胸片检查。近年来，SCT快速无间隔的容积扫描提高了CT发现小病灶的敏感性，在尘肺诊断中越来越受到重视，而HRCT是目前最能详细显示正常肺解剖和病理改变细节的一种影像学手段，能显著提高煤工尘肺微细病变的显示率［1］。本文对82例已明确诊断的煤工尘肺患者的SCT与HRCT资料进行分析总结，探讨两者的结合应用对提高尘肺诊断的价值。 1 资料与方法 1.1一般资料 搜集2008年12月至2009年4月来我院就诊的已明确诊断煤工尘肺患者82例，均为男性，年龄62岁～86岁，包括采煤工35例，采掘工47例，其中I期46例；Ⅱ期28例；Ⅲ期8例。 1.2方法 所有病例均采用Philips MX 4000 Dual CT扫描机行全肺螺旋扫描, 层厚8.4mm，层距8.4mm。扫描范围从肺尖到膈。然后在主动脉弓顶、气管隆凸、气管分叉下3cm、右膈上2cm［2］进行HRCT检查，另外再进行大阴影或疑似合并其他病变等兴趣区行HRCT检