关键词: 尘肺病, 结核, 肺, 共病现象, 疾病特征, 诊断, 鉴别

Abstract:

Pneumoconiosis complicated with pulmonary tuberculosis is the most severe comorbidity of pneumoconiosis, characterized by high prevalence, overlapping imaging signs that are difficult to distinguish, and a high rate of missed diagnosis and misdiagnosis. This condition greatly impairs patients’ health-related quality of life and tends to trigger diagnostic disputes, because diagnostic conclusions are directly linked to occupational capacity appraisal and occupational injury insurance benefits. Issued by the China Health Inspection Association in 2023, Guidelines for Chest Imaging Diagnosis of Pneumoconiosis Complicated with Pulmonary Tuberculosis (T/WSJD 31—2023) is China’s first special group standard for chest imaging diagnosis of pneumoconiosis complicated with pulmonary tuberculosis. Based on the epidemiological features, clinical misdiagnosis status and quality-of-life research evidence of pneumoconiosis combined with pulmonary tuberculosis in China, this paper systematically interprets the standard’s diagnostic principles, imaging classification criteria, CT examination indications, tuberculosis activity assessment, differential diagnosis system and standardized diagnostic workflow. This paper aims to help clinicians and occupational disease diagnosticians accurately understand and apply this standard, so as to improve the consistency and accuracy of diagnosis for pneumoconiosis complicated with pulmonary tuberculosis.

Key words: Pneumoconiosis, Tuberculosis, pulmonary, Comorbidity, Disease attributes, Diagnosis, differential