doi:10.19983/j.issn.2096-8493.20260197

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References 13

[1]	中华人民共和国国家卫生和计划生育委员会. GBZ 70-2015职业性尘肺病的诊断[S]. 2015-12-15.
[2]	中华预防医学会职业病分会尘肺病影像学组. 尘肺病胸部CT规范化检查技术专家共识(2020年版)[J]. 环境与职业医学, 2020, 37(10): 943-949. doi:10.13213/j.cnki.jeom.2020.20259.
[3]	Kusaka Y, Hering K G, Parker J E. International Classification of HRCT for Occupational and Environmental Respiratory Diseases[M]. Tokyo: Springer, 2005.
[4]	Hering K G, HOFMANN-PREIß K, Kraus T. Update: standardized CT/HRCT classification of occupational and environmental thoracic diseases in Germany[J]. Radiologe, 2014, 54(4): 363-384. doi:10.1007/s00117-014-2674-y. pmid: 24737105
[5]	Richard W W, Nestor M L, David N P. 高分辨率肺部CT[M]. 5版. 潘纪戍, 胡荣剑, 译. 北京: 中国科学技术出版社, 2017.
[6]	中华人民共和国国家卫生和计划生育委员会 GBZ 25-2014 职业性尘肺病的病理诊断[S]. 2014-10-13.
[7]	Yudin. Metaphorical Signs in Computed Tomography of Chest and Abdomen[M]. Switzerland: Springer Cham, 2014.
[8]	Akira M, Higashihara T, Yokoyama K, et al. Radiographic type p pneumoconiosis: high-resolution CT[J]. Radiology, 1989, 171(1):117-123. pmid: 2928514
[9]	International Labour Office. Guidelines for the use of the ILO International Classification of Radiographs of Pneumoconioses, Revised edition 2011[S]. 2022-07-17.
[10]	Şener M U, Şimşek C, Özkara Ş, et al. Comparison of the International Classification of High-resolution Computed Tomography for occupational and environmental respiratory diseases with the International Labor Organization International Classification of Radiographs of Pneumoconiosis[J]. Ind Health, 2019, 57(4): 495-502. doi:10.2486/indhealth.2018-0068. pmid: 30344228
[11]	Savranlar A, Altin R, Mahmutyazicioğlu K, et al. Comparison of chest radiography and high-resolution computed tomography findings in early and low-grade coal worker’s pneumoconiosis[J]. Eur J Radiol, 2004, 51(2):175-180. doi:10.1016/j.ejrad.2003.10.017. pmid: 15246524
[12]	Hansell Dm, Bankier Aa, Macmahon H, et al. Fleischner Society: glossary of terms for thoracic imaging[J]. Radiology, 2008, 246(3): 697-722. doi:10.1148/radiol.2462070712. pmid: 18195376
[13]	Dhileepan K T, Farid S. High-resolution CT chest findings in rare occupational lung diseases-An overview[J]. Int J Pharm Bio Sci, 2015, 6(1): B542-B548.

尘肺病种类		CT表现
矽肺	单纯型	①小结节:直径1~10mm,通常2~5mm,密度较高,边缘清楚,可钙化;沿小叶中心或淋巴管分布,多见于上肺区、中后部及右肺。 ②肺门及纵隔淋巴结:可有蛋壳样钙化
	复杂型	融合团块,上肺区中后部多见,与侧胸壁平行,瘢痕旁气肿明显;团块内有时可见钙化和/或空气支气管征
	急性矽肺(矽性蛋白沉着症)	两侧弥漫分布磨玻璃影,可伴有小叶中心结节、实变、铺路石征
煤工尘肺	单纯型	小结节的分布与矽肺类似,但结节偏小、密度较低;淋巴结蛋壳样钙化少见;少数病例为由基底部向上方发展的网状阴影
煤工尘肺	复杂型	融合团块,可伴有坏死、瘢痕旁气肿
石棉肺		早期呈胸膜下点状或分支状影、胸膜下线、胸膜下不规则小结节; 进展时呈小叶内间质增厚、小叶间隔增厚、牵拉性支气管扩张或细支气管扩张、蜂窝等; 肺部病变以肺基底部起始并逐渐向上方进展; 出现胸膜斑时,常为石棉肺的特征性病变
其他尘肺		类似矽肺或煤工尘肺。电焊工尘肺常呈小叶中心磨玻璃影,滑石尘肺和云母尘肺的融合团块和淋巴结影密度较高,铝尘肺以网状阴影为主、多分布上肺区、可伴牵拉支气管扩张等

项目	螺旋CT	备注
CT设备	探测器纵轴宽度不低于38mm、最薄层厚不大于0.625mm
扫描方向	从头侧至足侧	16层CT,可选择沿足侧至头侧
扫描体位	仰卧位	早期石棉肺可选择俯卧位
扫描范围	胸腔入口至肺下界膈面	深吸气末屏气检查
扫描机架倾斜角度	0°
管电压	不低于110kV
管电流	200mA左右	智能管电流控制
螺距	0.75~1.00	16层CT可适当加大螺距
旋转速度	不大于0.5s/周
扫描视野	30~35cm
重建层厚	① 5mm层厚 ② 16层CT,≤1.5mm; ≥64层CT,≤1mm
重建间隔	50%~75%
重建矩阵	512×512	有1024矩阵程序,推荐采用1024矩阵
重建算法	骨算法、软组织算法
图像后处理技术	多平面重组、最大密度投影
对比剂	无	进行职业病检查和诊断鉴定时,不须使用对比剂

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