CAJ | 학술논문

目的为评价数字化摄影(direct digital radiography,DR)胸片在石棉肺诊断上的可行性,对DR胸片和传统胶片-增感屏摄影(film screen radiography,FSR)胸片的石棉肺影像表现进行差异比较和一致性分析.方法以60例石棉肺患者为研究对象,同一天拍摄DR胸片和FSR胸片,比较两种胸片在石棉肺小阴影形态、密集度、胸膜病变和期别判定上的差异.结果 60例研究对象胸片小阴影形态表现为s、t和p,以不规则小阴影s、t为主,FSR胸片小阴影为s或t影的占95.0％,DR胸片占91.7％.小阴影广泛分布在6个肺区,以中下肺表现明显.两种胸片对小阴影形态判定的构成比和在肺区中的分布比例的差异均无统计学意义(P＞0.05).两种胸片对60例研究对象肺区密集度诊断的一致率为64.2％(231/360),k=0.62 (95％CI:0.54～0.69).两种胸片对43例小阴影形态判定完全一致的研究对象(258组肺区)密集度比较,两种胸片的一致率为81.0％(209/258),k=0.79 (95 ％CI:0.72～0.87).FSR胸片判定胸膜增厚10例(16.7％,10/60),与DR片12例(20.0％,12/60)相比,差异无统计学意义(P＞0.05).FSR胸片判定Ⅰ期石棉肺53例(88.3％,53/60),Ⅱ期7例(11.7％,7/60),DR片Ⅰ期石棉肺51例(85.0％,51/60),Ⅱ期9例(15.0％,9/60).2种胸片诊断期别构成比比较,差异无统计学意义(P＞0.05).FSR和DR胸片对60例研究对象尘肺期别的判定的一致率为93.3％(56/60),k=0.71 (95％CI:0.45～0.98).结论 DR胸片在石棉肺小阴影分布、密集度判定和胸膜病变识别上与FSR相似.
목적 위평개수자화섭영(direct digital radiography,DR)흉편재석면폐진단상적가행성,대DR흉편화전통효편-증감병섭영(film screen radiography,FSR)흉편적석면폐영상표현진행차이비교화일치성분석.방법 이60례석면폐환자위연구대상,동일천박섭DR흉편화FSR흉편,비교량충흉편재석면폐소음영형태、밀집도、흉막병변화기별판정상적차이.결과 60례연구대상흉편소음영형태표현위s、t화p,이불규칙소음영s、t위주,FSR흉편소음영위s혹t영적점95.0％,DR흉편점91.7％.소음영엄범분포재6개폐구,이중하폐표현명현.량충흉편대소음영형태판정적구성비화재폐구중적분포비례적차이균무통계학의의(P＞0.05).량충흉편대60례연구대상폐구밀집도진단적일치솔위64.2％(231/360),k=0.62 (95％CI:0.54～0.69).량충흉편대43례소음영형태판정완전일치적연구대상(258조폐구)밀집도비교,량충흉편적일치솔위81.0％(209/258),k=0.79 (95 ％CI:0.72～0.87).FSR흉편판정흉막증후10례(16.7％,10/60),여DR편12례(20.0％,12/60)상비,차이무통계학의의(P＞0.05).FSR흉편판정Ⅰ기석면폐53례(88.3％,53/60),Ⅱ기7례(11.7％,7/60),DR편Ⅰ기석면폐51례(85.0％,51/60),Ⅱ기9례(15.0％,9/60).2충흉편진단기별구성비비교,차이무통계학의의(P＞0.05).FSR화DR흉편대60례연구대상진폐기별적판정적일치솔위93.3％(56/60),k=0.71 (95％CI:0.45～0.98).결론 DR흉편재석면폐소음영분포、밀집도판정화흉막병변식별상여FSR상사.
Objective To evaluate the feasibility of direct digital radiography (DDR) in the diagnosis of asbestosis,and to analyze the difference and similarity between DDR and film-screen radiography (FSR) in terms of the radiographic features of asbestosis.Methods A total of 60 cases of asbestosis underwent FSR and DDR of the chest in the same day.The FSR and DDR findings were compared with respect to shapes and profusion of small opacities,pleural abnormality,and diagnostic stages.Results The patients showed "s","t",and "p" small opacities on chest images,with irregular "s" and "t" ones predominating (FSR:95.0％; DDR:91.7％).The small opacities were widely distributed in six lung zones,especially in middle and lower zones.The shapes and distribution of small opacities did not differ significantly between FSR and DDR findings (P＞0.05).For all the 60 cases,the two radiographies demonstrated a concordance rate of 64.2％ (231/360) for the profusion of small opacities in lung zones (k=0.62,95％CI:0.54～0.69),and for the 43 cases (258 lung zones)who displayed identical small opacity shapes on the two radiographies,the concordance rate was 81.0％ (209/258) (k=0.79,95％CI:0.72～0.87).FSR revealed 10 cases (16.7％) of pleural thickening,compared to 12 cases (20.0％) on DDR (P＞0.05).FSR revealed 53 cases (88.3％) of stage Ⅰ asbestosis and 7 cases (11.7％) of stage Ⅱ asbestosis,compared to 51 cases (85.0％) and 9 cases (15.0％) on DDR (P＞0.05).There was no significant difference in diagnostic stages between the two radiographies (P＞0.05),demonstrating a concordance rate of 93.3％ (56/60) (k=0.71,95％CI:0.45～0.98).Conclusion DDR is similar to FSR in determining the shapes,distribution,and profusion of small opacities,pleural abnormality,and diagnostic stages.