CT can improve the diagnostic accuracy in the staging of silicosis
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摘要:
目的 探讨CT对矽肺分期的诊断价值。 方法 选取我院2022年1月~2023年1月的80例矽肺患者，所有患者均行CT检查，对比CT对矽肺分期的诊断结果及其临床诊断结果的一致性，计算CT对矽肺分期的诊断效能。 结果 CT征象分析显示，80例矽肺患者中，20例患者在双肺上、中、下区均存在结节，36例患者在4个肺区存在结节，24例患者在2个肺区存在结节；39例患者无团块，13例患者团块为1~3 cm，28例患者团块 > 3 cm；54例患者存在肺结节密度增加；80例患者存在不同程度淋巴结肿大，57例患者发生于两肺门区淋巴结，23例患者发生于纵隔；60例患者存在胸膜增厚，累及叶间胸膜和脏壁胸膜。临床诊断结果显示，80例矽肺患者中，Ⅰ期24例，Ⅱ期36例，Ⅲ期20例；CT检查结果显示，Ⅰ期26例，Ⅱ期35例，Ⅲ期19例，与临床诊断结果的Kappa值分别为0.884、0.823、0.898，提示两者具有良好的一致性。CT对矽肺分期诊断的总准确度91.25%，CT对Ⅰ期、Ⅱ期、Ⅲ期分期诊断的准确率分别为95.00%、91.25%、96.25%，敏感度分别为95.83%、88.89%、90.00%，特异性分别为94.64%、93.18%、98.33%，阳性预测值分别为88.46%、91.43%、94.74%，阴性预测值分别为98.15%、91.11%、96.72%。 结论 CT在矽肺患者诊断中起着积极作用，能提高矽肺分期的诊断准确性，具有良好的诊断效能。 Abstract:Objective To explore the diagnostic value of CT in the staging of silicosis. Methods Eighty silicosis patients from our hospital from January 2022 to January 2023 were selected, and all patients underwent CT examination. The diagnostic results of CT for silicosis staging and the consistency of clinical diagnostic results were compared, and the diagnostic efficacy of CT for silicosis staging was calculated. Results The CT sign analysis showed that among 80 silicosis patients, 20 patients had nodules in the upper, middle, and lower regions of both lungs, 36 patients had nodules in 4 lung regions, and 24 patients had nodules in 2 lung regions; 39 patients had no masses, 13 patients had masses ranging from 1 to 3cm, and 28 patients had masses greater than 3cm; 54 patients had increased pulmonary nodule density; 80 patients had different degrees of Lymphadenopathy, 57 patients had lymph nodes in hilar region, 23 patients had in mediastinum; 60 patients had pleural thickening, involving interlobular pleura and visceral pleura. The clinical diagnosis results showed that there were 24 cases in stage Ⅰ, 36 cases in stage Ⅱ, and 20 cases in stage Ⅲ among 80 silicosis patients; The CT examination results showed that there were 26 cases in Phase Ⅰ, 35 cases in Phase Ⅱ, and 19 cases in Phase Ⅲ. The Kappa value was 0.884, 0.823, 0.898, respectively, indicating good consistency between the two. The overall accuracy of CT in staging diagnosis of silicosis was 91.25%. The accuracy of CT in staging diagnosis of stage Ⅰ, stage Ⅱ and stage Ⅲ was 95.00%, 91.25%, 96.25%, respectively. The sensitivity was 95.83%, 88.89%, 90.00%, respectively. The specificity was 94.64%, 93.18%, 98.33%, respectively. The positive predictive value was 88.46%, 91.43%, 94.74%, respectively, and the negative predictive values was 98.15%, 91.11%, 96.72%, respectively. Conclusion CT plays a positive role in the diagnosis of silicosis patients, can improve the diagnostic accuracy of silicosis staging, and has good diagnostic efficacy. -
Key words:
- silicosis /
- CT /
- clinical staging /
- diagnostic value
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图 1 矽肺患者CT图像
Figure 1. CT images of silicosis. A, B: View of axial and coronal showed that patients had nodules in the upper, middle, and lower regions of both lungs; C, D: Another patients, view of axial and coronal showed that patients had masses and diffuse small nodules.
表 1 CT对矽肺分期的诊断结果及其与临床诊断结果的一致性分析
Table 1. The consistency analysis of the diagnostic results of CT for silicosis staging and the clinical diagnostic results (n)
CT results Clinical diagnosis results Total Kappa value Stage Ⅰ Stage Ⅱ Stage Ⅲ Stage Ⅰ 23 3 0 26 0.884 Stage Ⅱ 1 32 2 35 0.823 Stage Ⅲ 0 1 18 19 0.898 Total 24 36 20 80 
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表 2 CT对矽肺分期的诊断效能
Table 2. The diagnostic efficacy of CT for silicosis staging (%)
CT examination results Accuracy Sensitivity Specificity Positive predictive value Negative predictive value Stage Ⅰ 95.00（76/80） 95.83（23/24） 94.64（53/56） 88.46（23/26） 98.15（53/54） Stage Ⅱ 91.25（73/80） 88.89（32/36） 93.18（41/44） 91.43（32/35） 91.11（41/45） Stage Ⅲ 96.25（77/80） 90.00（18/20） 98.33（59/60） 94.74（18/19） 96.72（59/61）
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