胸部X光與電腦斷層檢查在診斷複雜性塵肺症的比較

塵肺症患者因免疫力降低之故，所以併發肺結核及惡性腫瘤的機率較正常人爲高。藉電腦斷層術的幫助，我們相信由於傳統胸部X射線底片（俗稱X光片）上重疊影像的減少會增加診斷的正確性。我們對二十位患者（矽肺症及煤礦工人塵肺症者18人，石棉肺沈著症患者2人）採取了回溯性的探討，所有病人均曾接受了後前位胸部X光及電腦斷層術的檢查，對值得探討的病灶部分我們以細光柵的高解像力電腦斷層掃描予以複檢，期能獲得更精細的資料。由於電腦斷層檢查的幫助，使得其中2例得以診斷爲肺癌，2例在病理上也同意x光片的診斷，另1例無法確定但可增加其鑑別診斷。胸部x光顯示肋膜增厚者10例，CT18例，肋膜鈣化者無，CT4例，肋膜積水者3例，CT4例，高解像力電腦斷層檢查更可顯示次級肺小葉內的變化如局部氣腫，小葉問隔增厚，小支氣管壁增厚，這些均優於傳統胸部x光片。總言之，在高度懷疑有塵肺症合併症的病人，CT是一個有力且有利的工具。

關鍵字

肺部；電腦斷層術；塵肺症

並列摘要

Because of impaired immunity, patients with pneumoconiosis have higher incidince of pulmonary TB and malignancy than normal sbujects. By means of computed tomography (CT), we expected to decrease the default of superimposed shadows on conventional chest radiography and to increase the accuracy in diagnosis. Twenty patients (silicosis and coal worker pneumoconiosis in 18, and asbestosis in 2) were studied retrospectively. All had received posteroanterior chest radiography and CT, Thin section, high-resolution CT (HRCT) focusing the regions of interesting was also done. Owing to CT examination, 2 cases changed the x-ray findings and pathological diagnosis as lung cancer. The diagnosis was in agreement with pathological findings in 2 cases, The differential diagnosis was made in 1 case. Chest radiography showed pleural thickness in 10 cases, while CT showed that in 18 cases. Pleural calcification was missed by chest film but found in 4 by CT. Pleural effusion was noted in 3 by chest film and 4 by CT. HRCT is superior to conventional chest film in demonstrating the changes in the seconday pulmonary lobule such as focal emphysema, interlobular septa thickness and bronchiolar wall thickness. In general, in patients with highly suspected complicated pneumoconiosis, CT is a powerful and useful tool.

並列關鍵字

Lung ； computed tomography CT ； pneumoconiosis

國際替代計量

胸部X光與電腦斷層檢查在診斷複雜性塵肺症的比較

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