尘肺病胸部CT规范化检查技术专家共识（2020年版）<mml:math><mml:msup><mml:mi>S</mml:mi><mml:mn>2</mml:mn></mml:msup></mml:math>

中华预防医学会职业病专业委员会尘肺病影像学组

doi:10.13213/j.cnki.jeom.2020.20259

尘肺病胸部CT规范化检查技术专家共识（2020年版） $S^{2}$

doi: 10.13213/j.cnki.jeom.2020.20259

中华预防医学会职业病专业委员会尘肺病影像学组^,

详细信息

通讯作者:
王焕强, E-mail:wanghq@niohp.chinacdc.cn

中图分类号: R13
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出版历程
- 收稿日期: 2020-05-31
- 录用日期: 2020-09-16
- 发布日期: 2020-10-25

Consensus of experts on the technical specification of chest CT examination of pneumoconiosis (2020 edition)

Pneumoconiosis Imaging Group of Occupational Diseases Professional Committee of Chinese Preventive Medicine Association^,

More Information

Corresponding author: WANG Huan-qiang, E-mail:wanghq@niohp.chinacdc.cn

摘要

摘要: 高千伏X线胸片是我国GBZ 70—2015《职业性尘肺病的诊断》强制采用的尘肺病诊断、分期工具，常常需要联合应用计算机体层成像（CT）进行鉴别诊断，但胸部CT检查尘肺病缺乏规范性的技术指导。为此，中国卫生监督协会团体标准委员会批准了中国疾病预防控制中心职业卫生与中毒控制所关于《CT用于尘肺病辅助检查指南》的立项申请。在中华预防医学会职业病专业委员会尘肺病影像学组的指导下，项目组撰写了本共识。其中：鉴于尘肺病检查的特殊性，对CT机和附属设备的配置制定了具体要求；为了获得高质量图像，对扫描前的准备、图像层厚等扫描和图像重建参数组合制定了具体要求；基于CT是数字图像的基础，对图像后处理方法提出了具体要求；为了获得规范的大数据，对图像数据的存储也做了相应要求；为了方便使用，制定了CT图像质量评价方法。
- 尘肺 /
- 胸部CT /
- 技术规范 /
- 共识
Abstract: High kV chest X-ray radiographs are a compulsory tool for the diagnosis and staging of pneumoconiosis stipulated by the Diagnosis of occupational pneumoconiosis (GBZ 70-2015) in China, and often combine with computed tomography (CT) examination for further differential diagnosis. However, chest CT examination for pneumoconiosis requires standardized technical guidance. Thus, the Group Standards Committee of the China Health Inspection Association approved the application of the Institute of Occupational Health and Poison Control of the Chinese Center for Disease Control and Prevention to develop a guideline for chest CT assisting examinations of pneumoconiosis patients. Under the direction of the Pneumoconiosis Imaging Group of Occupational Diseases Professional Committee of Chinese Preventive Medicine Association, the "Consensus of experts on the technical specification of chest CT examination of pneumoconiosis (2020 edition)" was drafted. Given the particularity of pneumoconiosis examination, the configurations of CT machines and auxiliary equipment were specified. To obtain high-quality images, specific requirements were made for the scanning and image reconstruction parameters such as preparation before scanning and image slice thickness. Based on the fact that CT outputs digitized images, image post-processing methods were addressed. To achieve standardized big data, the archiving of image data was detailed. For convenient application, the evaluation method of CT image quality was established.
- pneumoconiosis /
- chest CT /
- technical specification /
- consensus
利益冲突 无申报

Competng interests None declared
专家组成员（按单位和姓氏名称拼音排序）
北京朝阳医院：叶俏、张镭；北京地坛医院：陈步东；北京世纪坛医院：温庭国；北京市化工职业病防治院：李珏、王建国；北京市疾病预防控制中心：张君；北京医院：潘纪戌；鄂尔多斯健康体检中心：贺咏平；广东省职业病防治院：陈嘉斌、梁伟辉、夏丽华；广西壮族自治区职业病防治研究院：李忠学；广州市职业病防治院：蒋文中；贵州省第三人民医院：黎东霞；国家卫生健康委职业安全卫生研究中心：钱青俊、王峥、张建芳；哈尔滨医科大学第二附属医院：赵雁鸣；杭州医学院：陈钧强、张幸；黑龙江省劳动卫生职业病研究院：刘锡诚；湖北省中西医结合医院：凌瑞杰、祝望才；湖南省胸科医院：庞菁、姚其能；湖南省职业病防治院：陆长城；华中科技大学同济医学院附属协和医院：余建明；淮北矿业股份有限公司职业病防治院：丁新平、姚玉龙；吉林省前卫医院：李岩；江苏省疾病预防控制中心：丁帮梅、谢丽庄；晋城煤业集团总医院：李海学；南京大学医学院附属鼓楼医院：蔡后荣；内蒙古科技大学包头医学院第一附属医院：王琳琳；青岛市中心医院：陈艳霞；山东省医学影像学研究所：柳澄；山东省职业卫生与职业病防治研究院：蔡志春、崔萍、闫永建；陕西省人民医院：李健；上海市肺科医院：毛翎；深圳市职业病防治院：李智民、罗军；沈阳市第九人民医院：阎波；四川大学华西第四医院：彭莉君；无锡市人民医院：吴波；新疆维吾尔自治区职业病医院：窦红；烟台北海医院：王宝堂；应急管理部北戴河康复院：陈刚、刘贺；应急总医院：李宝平；云南省第三人民医院：宋繁锐；中国疾病预防控制中心职业卫生与中毒控制所：李涛、孙承业、王焕强、余晨；重庆市公共卫生医疗救治中心：吕圣秀；重庆市职业病防治院：金盛辉；淄博市职业病防治院：王成霞。
秘书
中国疾病预防与控制中心职业卫生与中毒控制所：吕向裴、齐放。

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表 1 尘肺病胸部CT扫描方案

Table 1. Chest CT scanning protocol for pneumoconiosis

参数	螺旋CT (HRCT)	备注
CT设备	CT (≥ 64层）
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	200 mA左右	智能管电流控制
螺距	0.75~1	16层CT可适当加大螺距
旋转速度	不大于0.5s·周^-1
扫描视野	30~35cm
重建层厚	①5 mm层厚 ②16层CT，≤1.5mm; ≥ 64层CT， ≤ 1mm
重建问隔	50%~75%
重建矩阵	512x512	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	进行职业病检查和鉴定时，不需使用对比剂

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参考文献(21)

[1]	职业性尘肺病的诊断: GBZ 70-2015[S].北京: 中国标准出版社, 2016.
[2]	International Labor Office (ILO). Guidelines for the use of the ILO international classification of radiographs of pneumoconioses[M]. Geneva:International Labor Office, 2011:48.
[3]	OGIHARA Y, ASHIZAWA K, HAYASHI H, et al. Progressive massive fibrosis in patients with pneumoconiosis:utility of MRI in differentiating from lung cancer[J]. Acta Radiol, 2018, 59(1):72-80. doi: 10.1177/0284185117700929
[4]	SUN J, WENG D, JIN C, et al. The value of high resolution computed tomography in the diagnostics of small opacities and complications of silicosis in mine machinery manufacturing workers, compared to radiography[J]. J Occup Health, 2008, 50(5):400-405. doi: 10.1539/joh.L8015
[5]	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
[6]	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
[7]	中华预防医学会劳动卫生与职业病分会职业性肺部疾病学组.尘肺病治疗中国专家共识(2018年版)[J].环境与职业医学, 2018, 35(8):677-689. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=ldyx201808001
[8]	中华医学会影像技术分会, 中华医学会放射学分会. CT检查技术专家共识[J].中华放射学杂志, 2016, 50(12):916-928. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhfsx201612004
[9]	European commission. European guidelines on quality criteria for diagnostic radiographic images[EB/OL].[2020-09-16]. https://www.sprmn.pt/pdf/EuropeanGuidelineseur16260.pdf.
[10]	祁吉. CT的昨天、今天和明天[J].继续医学教育, 2007, 21(25):8-11. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=jxyxjy200725003
[11]	WEBB W R, MÜLLER N L, NAIDICH D P. High-resolution CT of the lung[M]. 5th ed. Philadelphia:Wolters Kluwer Health, 2014.
[12]	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
[13]	中华医学会放射学分会心胸学组.低剂量螺旋CT肺癌筛查专家共识[J].中华放射学杂志, 2015, 49(5):328-335. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhfsx201505004
[14]	WOOD D E, KAZEROONI E, BAUM S L, et al. Lung cancer screening, version 1.2015:featured updates to the NCCN guidelines[J]. J Natl Compr Canc Netw, 2015, 13(1):23-34. doi: 10.6004/jnccn.2015.0006
[15]	REMY-JARDIN M, REMY J.胸部螺旋CT[M].刘士远, 李惠民, 董伟华, 译.北京: 中国医药科技出版社, 2001.
[16]	HANSELL D M, BANKIER A A, MACMAHON H, et al. Fleischner society:glossary of terms for thoracic imaging[J]. Radiology, 2008, 246(3):697-722. doi: 10.1148/radiol.2462070712
[17]	SUNDARAM B, CHUGHTAI AR, KAZEROONI EA. Multidetector high-resolution computed tomography of the lungs:protocols and applications[J]. J Thoracic Imaging, 2010, 25(2):125-141. doi: 10.1097/RTI.0b013e3181d9ca37
[18]	REMY-JARDIN M, CAMPISTRON P, AMARA A, et al. Usefulness of coronal reformations in the diagnostic evaluation of infiltrative lung disease[J]. J Comput Assist Tomogr, 2003, 27(2):266-273. doi: 10.1097/00004728-200303000-00028
[19]	陈步东, 马大庆, 关砚生, 等.低剂量多层CT最大密度投影检出肺小结节的研究[J].中华劳动卫生职业病杂志, 2006, 24(9):560-561. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhldwszyb200609017
[20]	REMY-JARDIN M, REMY J, ARTAUD D, et al. Diffuse infiltrative lung disease:Clinical value of sliding-thin-slab maximum intensity projection CT scans in the detection of mild micronodular patterns[J]. Radiology, 1996, 200(2):333-339. doi: 10.1148/radiology.200.2.8685322
[21]	ZOSKY G R, HOY R F, SILVERSTONE E J, et al. Coal workers' pneumoconiosis:an Australian perspective[J]. Med J Aust, 2016, 204(11):414-418. doi: 10.5694/mja16.00357