[Diagnostic value and clinical application of CT/HRCT for coal workers' pneumoconiosis with large opacities].

OBJECTIVE: To study the diagnostic value of CT/HRCT for the coal workers' pneumoconiosis (CWP) with large opacities. METHODS: Sixty-two patients with CWP were examined with both chest radiograph and CT/HRCT scan. Comparison was done. RESULTS: Large opacities were found in 19 patients in the chest radiograph of 62 patients with CWP. The detection rate was 30.6%. Thirty large opacities were found using chest radiograph. Forty-three patients with large opacities were found using the CT/HRCT. The detection rate was 69.4%. One hundred and twenty-three large opacities were found using CT/HRCT. Ninety-three more large opacities were found by CT/HRCT than by chest radiograph. The total detection rate of large opacities by CT was 4.1 times than by chest radiograph. Both differences were statistically significant (chi2 = 18.58, P < 0.01). CT/HRCT found all patients with large opacities detected in the chest radiograph. Seventeen patients with Stage III large opacities (>or= 1.0 cm x 2.0 cm) were found by the chest radiograph. The detection rate was 27.4% (17/62). Twenty-seven large opacities were found using chest radiograph. Thirty-four patients with Stage III large opacities were found using the CT/HRCT. The detection rate was 54.8%. The found Stage III large opacities added up to 67. The found Stage III large opacities by CT/HRCT were 40 more than using chest radiograph. Both differences were statistically significant (chi2 = 9.63, P < 0.01). CT/HRCT was reliable to show the morphology, the inside structure, the tiny lesion and the special location of the large opacities of CWP. It could provide more important information for differential diagnosis. CONCLUSION: CT/HRCT is significantly better than the chest radiograph in the diagnosis of complicated CWP. It can find the large opacities that the chest radiograph can not. It has a great diagnostic and practical value as an assistant examination method. CT/HRCT could be considered as the reference and evidence for staging progression in diagnosis of pneumoconiosis.

[CT quantitative study of coal miner's pneumoconiosis].

OBJECTIVE: To study the value of CT quantitativeness in the diagnosis of coal miner's pneumoconiosis. METHODS: 104 cases were examined by HRCT scan at top of aortic arc, carina of trachea, 3 cm below the bifurcation of bronchi, among them there were 87 patients with different stages of coal miner's pneumoconiosis, 17 cases of normal males as the control group. All images were determined by CT density histogram at specific region (- 1,024-0 HU). Calculated the percentage of each pixel included a varying number of CT value, and the ratio of density values in the specific region. RESULTS: The ratio of density values in the region of -983 (-) -778 HU was 87.31% in normal control group, and 80.51%, 75.27% and 72.99% respectively in the I, II, III stages of coal miner's pneumoconiosis. There were statistically significant differences among the groups (P < 0.01). CONCLUSION: CT quantitative histogram information was able to observe the fibrosis and its degree of coal miner's pneumoconiosis. It has a good diagnostic value for its reliability and objectiveness.

[The diagnostic value and morphologic manifestation of high resolution computerized tomography in coal miner's pneumoconiosis with pleural pathological changes].

OBJECTIVE: To analyse CT and high resolution computerized tomography (HRCT) diagnostic value and morphologic manifestation in coal miner's pneumoconiosis with pleural pathological changes. METHODS: One hundred and thirty-one cases of coal miner patients with pneumoconiosis (0(+) type: 14 cases, type I: 46 cases, type II: 58 cases, type III: 13 cases) and 20 normal people as control group were first examined by routine CT scan at 4 fixed slices, followed by HRCT examination at the region of interest (ROI). Meanwhile, all of them had high-kV chest radiography. RESULTS: According to the national standard of the People's Republic of China in the diagnosis of coal miner's pneumoconiosis with pleural plaque, 68 cases of pleural disease making up 51.91% (68/131) were found (type I accounted for 17.65%, type II 63.24%, type III 19.12%). The morphologic manifestation of pleural pathology by HRCT could be classified into four types: (1) nodular type: 73.38%, (2) flat type: 18.71%, (3) irregular type: 7.91%, (4) mixed type. The pleural pathological changes were found in thoracic wall pleura (65.02%), surface of mediastinum (22.16%), and pericardium (12.80%), but not found in the top of lung and costo-phrenic angles. The thickness of pleura was often about 5 approximately 10 mm (88.17%). CONCLUSION: Pleural pathological changes were not seldom seen in coal miner's pneumoconiosis. HRCT is a reliable examination method aiding routine CT to show pleural pathological changes, thus it has a great diagnostic and practical value. It is necessary to make a further comparison study between pathology and imagology.