The Advantage Of CT And X-ray In Pneumoconiosis Diagnosis:Systematic Review And Meta-analysis

Objectives:To provide a scientific basis for the application of CT in the diagnosis of pneumoconiosis compared with the advantages of CT and X-ray.Methods:Based on the data of20diagnose studies with met the inclusion and exclusion criteria of the literature before January2013, we have analyzed the advantages of CT and X-ray diagnostic studies in pneumoconiosis comprehensively, by using the appropriate statistics analyses, including a test for heterogeneity, the effect of the combination value, sensitivity analysis and bias estimation. Meta-analysis was used to estimate the combined OR and95%CI.Results:Twenty studies including1596subjects were finally selected in the analysis, which were all reported in Chinese. These studies were reported from1999to2012, the age-range of subjects was between22and85years old and the dust exposure time was between3and40years. Stratified analysis of diagnosis showed that the pooled diagnostic odds ratio (DOR) of the chest CT and X-ray for pneumoconiosis stages [no pneumoconiosis,0.67,95%CI:0.51-0.87; Ⅰ pneumoconiosis,1.37,95%CI:1.04-1.80; Ⅱ pneumoconiosis,0.90,95%CI:0.68-1.20;Ⅲ pneumoconiosis,1.50,95%CI:1.08-2.07]. Stratified analysis of diagnosis showed that the DOR of the chest CT and X-ray for imaging findings [small opacity,2.38,95%CI:1.41-4.01; large opacity,2.26,95%CI:1.76-2.91]. Stratified analysis of diagnosis showed that the DOR of the chest CT and X-ray for complications [pleural changes,4.00,95%CI:3.08-5.19; bullae of lung,3.73,95%CI:2.44-5.71; pulmonary tuberculosis,1.68,95%CI:1.25-2.26; lung cancer,2.71,95%CI:1.42-5.15; lymphadenectasis or calcification,4.09,95%CI:2.48-6.75; emphysema,3.12,95%CI:2.22-4.39]Conclusion:The results of meta-analysis showed that three subgroups (a total of11sub-groups) showed significant heterogeneity between the included studies by testing for heterogeneity. Effect value of merger analysis showed that the chest CT examination have a significant advantage to stage pneumoconiosis, find images and check out the complications, compared with X-ray in pneumoconiosis. The sensitivity analysis results showed that the differences of subgroups between the chest CT and X-ray in pneumoconiosis were statistically significant such as stage I, II, small opacity, large opacity and complications, and has an important clinical significance. The funnel plot analysis showed no significant publication bias. Above the strong evidences from OR and95%CI, chest CT has obvious advantages rather than the X-ray in pneumoconiosis diagnosis, and opened up a new and effective way for the clinical o pneumoconiosis diagnosis. Exploring the application of chest CT scans in pneumoconiosis diagnosis is looking forward to more research.