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目的比较数字化X射线摄影(DR)胸片和高千伏胸片在质量和诊断结果上的差异,探讨DR技术用于接尘工人职业健康监护的可行性。方法以319名某煤矿退休接尘工人作为研究对象,同时拍摄DR胸片和高千伏胸片,对2种胸片的质量和诊断结果进行比较分析。结果 DR胸片和高千伏胸片的优良率分别为99.68%(n=318)和92.79%(n=296),两者差异有统计学意义(2=20.17,P<0.01)。2种胸片在判定尘肺期别的一致率为92.76%,κ值为0.79,95%置信区间(CI)为0.70～0.88;总体密集度的一致率为91.03%,κ值为0.76,95%CI为0.68～0.85。结论在采用合适的图像处理参数后,DR胸片的质量能够符合尘肺病诊断的要求。2种胸片在诊断结果上有较好的一致性,可用于接尘工人职业健康监护。
Objective To compare the differences in quality and diagnostic results between digital radiography (DR) chest radiographs and high-kvv chest radiographs and explore the feasibility of using DR technique for occupational health monitoring of workers exposed to dust. Methods A total of 319 mine workers who took out the dust were selected as the research objects. At the same time, DR chest radiographs and high kV chest radiographs were taken to compare and analyze the quality and diagnostic results of the two kinds of radiographs. Results The excellent and good rates of DR chest radiograph and high kV chest radiograph were 99.68% (n = 318) and 92.79% (n = 296), respectively. There was significant difference between them (2 = 20.17, P <0.01). The concordance rates of the two kinds of chest radiographs in determining pneumoconiosis stage were 92.76%, κ value 0.79, 95% confidence interval (CI) 0.70 ~ 0.88; the consistency rate of overall intensity 91.03%, κ value 0.76, 95% CI is 0.68 ~ 0.85. Conclusion The quality of DR chest radiographs can meet the requirements of pneumoconiosis diagnosis after adopting appropriate image processing parameters. The two kinds of chest radiographs have better consistency in the diagnosis results and can be used for occupational health monitoring of dust-collecting workers.