【摘要】 目的 探讨胸部X线片和高分辨率电子计算机断层扫描(high resolution computed tomography, HRCT)对壹期电焊工尘肺病的诊断价值，为早期电焊工尘肺病的影像学诊断提供依据。方法 回顾性分析2020—2021年无锡市疾病预防控制中心57例壹期电焊工尘肺病患者的胸部高仟伏X线片与同期HRCT影像学图像，归纳总结病灶主要表现形式及分布特点，使用χ~2检验进行统计学分析。结果 57例壹期电焊工尘肺病患者中45例的胸部X线表现为以不规则小阴影为主，伴少量圆形小阴影(即s/p阴影),8例表现为p/s阴影，4例表现为t/q阴影，不同患者胸部X线表现差异有统计学意义(χ~2=80.684,P<0.05)。HRCT表现为小叶分支线状影31例，其中12例伴有两肺磨玻璃微小结节影；以小叶为中心的磨玻璃密度微小结节23例；两肺多发实性微小结节3例，不同患者的HRCT表现差异有统计学意义(χ~2=40.946,P<0.05)。57例壹期电焊工尘肺病患者伴有肺大泡8例，局限性肺气肿4例，肺结核2例，局部支气管扩张伴感染1例。结论 胸部高仟伏X线片对诊断壹期电焊工尘肺病具有传统优势，HRCT在显示结节数目和分布、早期肺气肿、肺门淋巴结增大、肺纤维化病变及胸膜改变等方面具有优势，可辅助尘肺病的分期诊断。在尘肺病诊断工作中应结合患者的实际情况，有针对性的进行胸部CT检查，以减少漏诊或误诊的发生。更多还原

【Abstract】 Objective To explore the diagnostic value of chest X-ray and high resolution computed tomography(HRCT) for the diagnosis of stage I welder′s pneumoconiosis, and to provide a basis for the imaging diagnosis of early-stage welder′s pneumoconiosis.Methods The chest high thousand volt radiographs and concurrent HRCT imaging images of 57 patients with stage I welder′s pneumoconiosis in Wuxi Center for Disease Control and Prevention from 2020 to 2021 were retrospectively analyzed.The main manifestations and distribution characteristics of the lesions were summarized and generalised and statistical analysis was performed using the χ~2 test.Results Among the 57 patients with stage I welder′s pneumoconiosis, 45 cases showed mainly small irregular shadows with a few small rounded shadows(i.e.,s/p shadows) on chest X-ray, 8 cases showed p/s shadows, and 4 cases showed t/q shadows.The difference in chest X-ray manifestations among different patients was statistically significant(χ~2=80.684,P<0.05).HRCT showed lobular branching linear shadows in 31 cases, of which 12 cases were accompanied by milled-glass micronodular shadows in both lungs.There were 23 cases of milled-glass density micronodules centered on lobules and 3 cases of multiple solid micronodules in both lungs, with a statistically significant difference in HRCT performance between different patients(χ~2=40.946,P<0.05).There were 57 cases with stage I welder′s pneumoconiosis patients with alveoli in 8 cases, restrictive emphysema in 4 cases, pulmonary tuberculosis in 2 cases, and localized bronchiectasis with infection in 1 case.Conclusion The chest high kilovoltage X-ray has traditional advantages in diagnosing the stage I welder′s pneumoconiosis.HRCT has advantages in displaying the number and distribution of nodules, early emphysema, enlarged hilar lymph nodes, pulmonary fibrosis lesions, and pleural changes etcetera, which can assist in the staged diagnosis of pneumoconiosis.In the diagnosis of pneumoconiosis, targeted chest CT examination should be carried out based on the actual situation of the patient in order to reduce the occurrence of missed diagnosis or misdiagnosis.更多还原