结核与肺部疾病杂志  2026, Vol. 7 Issue (5): 554-558    DOI: 10.19983/j.issn.2096-8493.20260189

• 标准解读 • 上一篇    下一篇

《T/WSJD 32—2023胸部CT辅助诊断尘肺病技术指南》团体标准解读

王焕强()   

  1. 中国疾病预防控制中心职业卫生与中毒控制所, 北京 100050
  • 收稿日期:2026-07-16 出版日期:2026-10-20 发布日期:2026-09-03
  • 通信作者: 王焕强 E-mail:wanghq@niohp.chinacdc.cn
  • 基金资助:
    国家科技重大专项(2024ZD0528901)

Interpretation of group standard T/WSJD 32—2023: Technical Guidelines of Chest CT for Aided Diagnosis of Pneumoconiosis

Wang Huanqiang()   

  1. National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
  • Received:2026-07-16 Online:2026-10-20 Published:2026-09-03
  • Contact: Wang Huanqiang E-mail:wanghq@niohp.chinacdc.cn
  • Supported by:
    National Major Science and Technology Projects(2024ZD0528901)

摘要:

尘肺病是我国危害最严重的法定职业病,现行诊断以高千伏/数字化X线摄影(digital radiography, DR)后前位胸片为核心依据,但存在解剖结构重叠、早期病灶检出率低、鉴别诊断能力不足等固有局限。近年来,胸部高分辨率计算机断层扫描(high-resolution computed tomography, HRCT)在尘肺病筛查与诊断中应用日益广泛,但因缺乏统一的扫描、重建与判读标准,导致机构间检查质量差异大,诊断一致性不足,严重影响诊断与鉴定公信力。2023年发布的《T/WSJD 32—2023 胸部CT辅助诊断尘肺病技术指南》是我国首部尘肺病CT辅助诊断专项团体标准,历经6年循证积累,遵循“先专家共识、后团体标准”的技术路径,基于大样本影像数据与多轮临床验证形成。本文结合标准编制背景与方法学依据,系统解读其适用定位、术语体系、全流程技术规范、重建后处理要求及质量控制体系,分析其与《GBZ 188—2025职业健康监护技术规范》及待修订的《GBZ 70职业性尘肺病的诊断》的衔接价值,并提出临床应用建议与未来升级方向,旨在指导职业病诊断人员准确把握标准内涵,规范CT辅助诊断,提升诊断一致性与准确性。

关键词: 尘肺, 体层摄影术, X线计算机, 诊断, 指南

Abstract:

Pneumoconiosis is the most prevalent and devastating statutory occupational disease in China. High-kilovoltage and digital radiography (DR) posteroanterior chest radiographs have long served as the core diagnostic modality, yet they have inherent limitations, including anatomical superimposition, low detection rate of early lesions, and limited capacity for differential diagnosis. In recent years, chest high-resolution computed tomography (HRCT) has been increasingly applied in pneumoconiosis screening and diagnosis. However, the absence of unified standards for scanning protocols, image reconstruction and interpretation criteria has led to considerable quality disparities across institutions and low inter-observer diagnostic consistency, which severely undermines the credibility of diagnosis and occupational disease appraisal. Issued in 2023, Technical Guidelines of Chest CT for Aided Diagnosis of Pneumoconiosis (T/WSJD 32—2023) is China’s first dedicated group standard for CT-aided pneumoconiosis diagnosis. Developed through a six-year evidence-based research process, it follows the technical pathway of “expert consensus first, group standard second”, and is established based on large-sample imaging data and multiple rounds of clinical validation. Grounded in the standard’s formulation background and methodological evidence, this paper systematically interprets its scope and application positioning, terminology system, whole-process technical specifications, reconstruction and post-processing requirements, and quality control system. It further analyzes its bridging value with Technical Specifications for Occupational Health Surveillance (GBZ 188—2025) and the forthcoming revised version of Diagnosis of Occupational Pneumoconiosis (GBZ 70), and puts forward clinical application recommendations and future upgrading directions. This paper aims to guide occupational disease diagnosticians to accurately understand the core connotation of the standard, standardize CT-aided diagnosis practices, and improve diagnostic consistency and accuracy.

Key words: Pneumoconiosis, Tomography, X-ray computed, Diagnosis, Guidebooks

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