The Comparative Study Of High-Kilovolt Radiography And High Resolution CT In Diagnosis Of Pneumoconsis

ObjectiveThis study aimed to compare the diagnosis of pneumoconioses by high-kilovolt radiography with that by high resolution CT based on the abnormalities provoked by the inhalation of dusts. The abnormalities include small opacities, large opacities, pleural thickening and other findings.Materials and Methods50 cases of pneumoconioses patients diagnosed by the Diagnostic Group of Occupational Disease in Taian Occupational Disease Hospital, were enrolled in this study between September 2009 and March 2011. The age of the patients range from 40 to 74 years-old, with the average of 59 years old. The industry distribution includes: 31 persons from coal mining, 12 persons from machinery manufacturing, and 7 from building construction. The dust exposed period are from five to 34 years, with the average of 25.9 years. Among them,26 are diagnosed as I stage pneumoconiosis, 13 are II stage, 1 is III stage, 10 are 0 stage.High-kilovolt X-ray exposure factor : 120kV, 320mA, 0.03-0.10s, focus-film distance:1.8m, grid ratio:12:1. X-ray beam direction: PA, expose after taking a deep breath and hold in. Medium screens, 356mm×356mm (14"×14") blue base film, the film is processed by automatic processor.MSCT scan parameters: slice thickness: 10 mm, pitch: 0.75:1, 120kV, 120mA , standard algorithm. MSCT scans were obtained with the patient in the supine position after a full inspiration and during suspended respiration. 7-9 HRCT scans would subsequently obtained from aortic arch to diaphragm, with 1.25mm slice thickness, 10mm slice distance, 140kV, 250mA. Images were reconstructed with a high-resolution algorithm. Lung window: -650/1600 Hu; soft-tissue window: 40/360 Hu. ResultParenchymal abnormalities in high-kilovolt X-ray include rounded or irregular small opacities, category 1 or category 2. Syndrome: emphysema 8 case, pleural thickening 5 case, tuberculosis 3 case.MSCT features: multiple well-defined nodules, predominantly located in the middle and upper lung zone; reticular opacities. HRCT findings include nodules, interlobular septal thickening, peribronchovascular interstitium thickening, subpleural line. Syndrome: emphysema 21 case, bullae 8 case, pleural thickening 15 case, tuberculosis 5 case, hilar and mediastinal lymph node enlargement 12 case, ground-glass opacities 5 case.Five cases in the 10 cases diagnosed as stage 0 by high-kilovolt X-ray, are diagnosed as stage I by CT; 2 in 26 diagnosed as stage I by high-kilovolt X-ray, are diagnosed as stage II; 1 in 26 diagnosed stage I by high-kilovolt X-ray are diagnosed as stage 0.ConlusionHRCT could describe the secondary lobule of the lung, demonstrate early characteristic lesions of pulmonary fibrosis, subtle emphysema and honeycombing.1. High-kilovolt X-ray fit current diagnostic criteria of pneumoconiosis, yet there is false negative or false positive.2. There are so many observational items in HRCT, that it could disprite the pneumoconiosis completely, and help diagnose earlier.3. The dividing of lung field on the basis of slice in HRCT does not make difference in pneumoconiosis'diagnoses ang classification.