摘要
目的探讨CT阈值分割法联合肺功能指标对早期煤工尘肺(CWP)诊断的临床价值。方法回顾性分析于职业病防治所诊断的Ⅰ期CWP组133例和无尘肺组64例煤矿工人的临床、肺功能及肺部HRCT影像资料,基于密度阈值分割法得到CT值分别≤-950 HU、-950 HU~-700 HU、-700 HU~-200 HU、>-200 HU的肺容积比(%AA)及所占肺容积、肺总容积(TLV);比较两组间临床资料、肺功能指标和高分辨率CT(HRCT)定量参数的差异,将有意义的指标纳入多因素分析并采用ROC曲线分析其对早期CWP的诊断价值。结果多因素Logistic回归分析结果显示接尘年限、肺功能指标最大呼气中段流量(MMEF)、HRCT定量参数%AA-700~-200是煤矿接尘人群发生早期CWP的独立影响因素(P<0.05)。接尘年限联合肺功能指标MMEF、HRCT定量参数%AA-700~-200以及接尘年限、肺功能指标联合HRCT定量参数诊断早期CWP的曲线下面积分别为0.957(95%CI:0.930~0.984)、0.807(95%CI:0.747~0.867)和0.926(95%CI:0.890~0.963),最终三者联合诊断的效能显著优于单独诊断(P<0.05),其敏感度和特异度分别为88.0%和95.3%。结论接尘年限、肺功能指标MMEF联合HRCT定量参数%AA-700~-200对早期CWP的诊断具有重要意义。
Objective To explore the clinical value of CT threshold segmentation combined with pulmonary function indexes in the diagnosis of early coal worker’s pneumoconiosis(CWP).Methods The clinical,pulmonary function and HRCT imaging data of 133 coal miners in the phaseⅠCWP group and 64 coal miners in the pneumoconiosis group diagnosed by occupational disease prevention and control were retrospectively analyzed,and the lung volume ratio(%AA)and lung volume of≤-950 HU,-950 HU--700 HU,-700 HU--200 HU,and>-200 HU,respectively,were obtained based on the density threshold segmentation method.Total lung volume(TLV),the differences in clinical data,pulmonary function indexes and quantitative parameters of HRCT between the two groups were compared,and meaningful indicators were included in multivariate analysis,and ROC curves were used to analyze their diagnostic value for early CWP.Results The results of multivariate logistic regression analysis showed that the dust exposure years,pulmonary function index MMEF and HRCT quantitative parameters%AA-700--200 were the independent influencing factors for the early occurrence of CWP in coal mine dust exposure population(P<0.05).The AUC of early CWP in the diagnosis of early CWP by the dust age combined with pulmonary function indexes MMEF and HRCT quantitative parameters%AA-700--200 and the dust exposure years and pulmonary function indexes combined with HRCT quantitative parameters were 0.945(95%CI:0.913-0.977),0.807(95%CI:0.747-0.867)and 0.931(95%CI:0.896-0.965),the final combined diagnosis of the three was significantly better than that of the single diagnosis(P<0.05),and its sensitivity and specificity were 85.70%and 96.90%.Conclusion The age of dust exposure and pulmonary function index MMEF combined with HRCT quantitative parameter%AA-700--200 are of great significance for the diagnosis of early CWP.
作者
王莉
张倩
王灵杰
岳华杰
石彩云
张新日
卫阳阳
张华
WANG Li;ZHANG Qian;WANG Lingjie(School of Medical Imaging,Shanxi Medical University,Taiyuan,Shanxi Province 030001,P.R.China)
出处
《临床放射学杂志》
北大核心
2024年第9期1500-1505,共6页
Journal of Clinical Radiology
基金
中央级公益性科研院所科研业务项目(编号:2020-PT320-005)。
关键词
煤工尘肺
高分辨率计算机断层成像
定量分析
肺功能
Coal worker’s pneumoconiosis
High-resolution computed tomography
Quantitative analysis
Pulmonary function
