直读数字式摄影应用于尘肺病诊断的可行性研究
Feasibility Study of Direct Digital Radiography in Pneumoconiosis Diagnosis
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摘要:
目的 研究直读数字式摄影(DR)和传统胶片-增感屏(FSR)摄影对尘肺病小阴影形态和密集度辨识的可比性与一致性,评估直接读出DR胸片摄影技术在尘肺病诊断中的可行性和技术关键。 方法 以204名尘肺病人和31名粉尘作业工人为研究对象,同期拍摄FSR片和DR片,对FSR片和从显示器直接读取DR片的胸片质量、小阴影形态、肺区小阴影密集度和大阴影的检出率进行比较分析。 结论 FSR废片率明显较DR高(P<0.001);两种胸片在判定肺区小阴影密集度上有较好的一致性(κ=0.77),从上肺区(κ=0.82)、中肺区(κ=0.75)到下肺区(κ=0.68)一致性略有降低;两种胸片对小阴影形态的判定没有明显差异(FSR 93.2%,DR 90.0%,P>0.05);对大阴影的识别表现一致(22.9%,44/192)。 结论 DR胸片质量优于FSR胸片,在尘肺病小阴影形态、密集度的判定和大阴影的识别上与FSR相似。 Abstract:Objective To evaluate technical key points and applicability of direct digital radiography(DR) images in identification of pneumoconiosis, we compared the shape/size and profusion of small opacities between film screen radiography (FSR)and DR technique. Methods We enrolled 204 pneumoconiosis patients and 31 workers exposed to dust with FSR and DR images obtained, compared image quality, small opacity profusion and shape, large opacity identification between these two modalities. Results Significantly more FSR images were unacceptable for classification purposes compared to DR images (P<0.001). The inter-modality agreement of small opacities was good with a weighted kappa (κ)of 0.77. The inter-modality agreement was high in the upper zones (κ=0.82), intermediate in the middle zones (κ=0.75) and low in the lower zones (κ=0.68). The identification of small opacities was close (93.2% FSR and 90.0% DR) and the distributions of shape between FSR and DR did not significantly differ(P>0.05). A complete agreement was achieved in the recognition of large opacities between modalities with 22.9% (44/192)of radiographs classified as having at least one large opacity in the same 44 subjects. Conclusion DR im ages with soft copy display are equivalent or superior to FSR technique with respect to the image quality and the recognition/classification of small parenchymal lung opacities.
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