透過您的圖書館登入
IP:3.22.181.209
  • 期刊

石綿塵肺症放射診斷之文獻回顧

A Prescriptive Study of Compressed Air Working Environment and Dysbaric Osteonecrosis

摘要


石綿主要是一群是纖維狀矽酸鹽的總稱,抗酸鹼、絕緣及不易破壞等特性,石綿在工業上的使用廣泛。石淿對健康的危害主要在呼吸道,會引起石綿塵肺症、肋膜斑、肋膜變厚等肺部纖維化及間皮細胞癌、喉癌等癌症。目前可用以監測及診斷石綿相關疾病的放射檢查有三項,分別為胸部X光片、電腦斷層及高顯像度電腦斷層。石綿暴露引起對胸部X光片變化可能出現於助膜實質,其發現及判讀可依據國際勞工組織所頒佈的標準。至於在電腦斷層及高顯像度電腦斷層檢查上就沒有統一的標準,一般而言,石綿暴露在電腦斷層上的表徵有(1)助膜斑(2)良性助膜積水(3)助膜增厚(4)圓形肺塌陷及良性纖維化腫塊;在高顯像度電腦斷層的檢查發現上,除了類似電腦斷層的發現外,另外還有以下五種表徵:(1)肋膜下線(supbleural lines)(2)肺間質短線(interstitial short lines)(3)肋膜下腫塊(subpleural density)(4)肺實質纖維帶(parenchymal band)(5)蜂窩狀變化(honeycombing)。三種檢查中,以高顯像度電腦斷層的靈敏度最高,電腦斷層次之,胸部X光片最差,所需成本則相反。胸部X光片適用於大規模的篩檢,而電腦斷層,尤其是是高顯像度電腦斷層,在對石綿相關疾病的早期發現及早期診斷上較為適用。

關鍵字

無資料

並列摘要


Asbestos has been widely sued in for more than 40 years. Asbestos is a collective term for some metamorphic. Fibrous, mineral silicates. Most of the asbestos was used for brake lining, con-strction materials, and insulation. Asbestos-related disorders can be divided into malignant and nonmalignant diseases. The nonmalignant diseases include asbestosis, pleural effusion, pleural thickening, pleural calcifications or plaque, and skin corns. The malignant disorders related to asbestos exposure include lung cancer, pleural or peritoneal mesothelioma, stomach cancer and laryngeal cancer. Although asbestos workers in Taiwan have been ling-term and heavily exposed to asbestos, only three cases of asbestosis were reported in the previous literatures. None of cancer has been reported to be associated with asbestos exposure. The possible reason for the underestimation of the prevalence of asbestosis may be due to underdetection by regular chest radiography with limited resolution. Another possible reason was due to ignorance of radiographic reader without detailed occupational exposure histoy. The radiological examinations used to detect asbestos-related disorders are chest X ray com-puted tomography and high resolution computed tomography. Chest film is most common method. The findings of chest films was classified by ILO, including plaque, thickening an profusion. In CT and GRCT, no uniform classification was used. Pleural plaques, effusions, diffuse pleural thickening ,fibrotic mass and asbestosis were recognized as the common manifestations of asbestos-related disease in CT scan, As CT scan, the findings of asbestos-related in HRCT were still controversial. Five findings (curvilinear subpleural lines, thickened interstitial short lines, suabpleural dependent density, parenchymal bands, and honeyconmbing)were noted in many studies, Because of greater sensitivities and specificity, HRCT is a better selection in diagnosis and early detection of asbestos-related disease.

並列關鍵字

無資料

延伸閱讀