摘要
目的对比尘肺大阴影与原发性肺癌肿块的CT影像特征,分析CT影像特征对尘肺大阴影与原发性肺癌的鉴别诊断价值。方法于2022年9月,选择2020年1月至2021年6月在淄博市职业病防治院住院的43例叁期尘肺病患者和同期在济宁医学院附属医院病理确诊的52例原发性肺癌患者作为调查对象,对比两组患者胸部CT影像中尘肺大阴影或肺癌肿块及周围组织的影像特点。使用单因素分析、聚类分析和交叉分析,筛选出有统计学意义的指标作为自变量,以尘肺病和肺癌作为因变量,进行logistic回归分析。结果尘肺大阴影与原发性肺癌肿块的CT影像单因素比较,病变形态不规则、CT值、钙化、空洞、棘突、液化坏死、卫星灶、肿块旁气肿、短毛刺、胸膜增厚等差异均有统计学意义(P<0.05)。病变CT值≥92 HU(CT值异常)、钙化、周围有卫星灶、胸膜肥厚、肿块旁气肿、病变边缘有棘突、病变形态不规则等是叁期尘肺的典型特征,具有多个特征聚集性;病变出现液化坏死、外形为圆形或类圆形、有空洞、跨叶间胸膜等是肺癌的典型特征。以卫星灶、棘突、胸膜肥厚、病变CT值异常和液化坏死构建的logistic回归模型R2=0.880,区分度为95.3%。结论病变CT值异常、钙化、周围有卫星灶、胸膜肥厚、边缘有棘突、液化坏死、跨叶间胸膜和空洞等影像特征可区分叁期尘肺大阴影和肺癌肿块影。
ObjectiveTo compare the CT image characteristics of pneumoconiosis large shadow and primary lung cancer mass,and analyze the value of CT image characteristics in the differential diagnosis of pneumoconiosis large shadow and primary lung cancer.MethodsIn September 2022,43 patients with stageⅢpneumoconiosis who were hospitalized in Zibo Occupational Disease Prevention Hospital from January 2020 to June 2021 and 52 patients with primary lung cancer who were confirmed by pathology in the Affiliated Hospital of Jining Medical University during the same period were selected as the investigation objects,and the image characteristics of pneumoconiosis large shadow or lung cancer mass and surrounding tissues in the chest CT images of the two groups were compared.Univariate analysis,cluster analysis and cross analysis were used to screen out statistically significant indicators as independent variables,and pneumoconiosis and lung cancer as dependent variables for logistic regression analysis.ResultsThere were statistically significant differences between large shadow of pneumoconiosis and primary lung cancer mass in single factor CT imaging,such as irregular shape of lesions,CT attenuation value,calcification,cavitation,spiculation,liquefactive necrosis,satellite lesions,adjacent emphysema,short spicules,and pleural thickening(P<0.05).CT value≥92 HU(abnormal CT attenuation value),calcification,peripheral satellite lesions,pleural thickening,parapunctal emphysema,spines on the lesion margin,irregular lesion morphology were typical features of stageⅢpneumoconiosis,with multiple features of aggregation.The typical features of lung cancer were liquefaction necrosis,round or quasi-round appearance,cavitation and interlobar pleura.A logistic regression model was constructed using satellite lesions,spiculation,pleural thickening,and lesion abnormal CT attenuation value had an R 2 of 0.880 and an accuracy of 95.3%for differentiation.ConclusionAbnormal CT attenuation value,calcification,peripheral satellite lesions,pleural th
作者
王成霞
靳毅
柳澄
刘真
仇路
王焕强
Wang Chengxia;Jin Yi;Liu Cheng;Liu Zhen;Qiu Lu;Wang Huanqiang(Radiology Department of Zibo Occupational Disease Prevention Hospital,Zibo 255000,China;Imaging Department of Shandong Provincial Hospital,Jinan 255021,China;National Institute for Occupational Health and Poison Control,Chinese Center for Disease Control and Prevention,Beijing 100050,China)
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
北大核心
2024年第7期523-529,共7页
Chinese Journal of Industrial Hygiene and Occupational Diseases
基金
山东省医药卫生科技发展计划项目(202009010872)。
关键词
尘肺
肺癌
影像
计算机体层扫描
Pneumoconiosis
Lung cancer
Image
Computed tomography,CT
