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目的评价MRI对煤工尘肺进行性块状纤维化(PMF)病灶各种征象的显示能力及诊断价值。方法对已确诊的21例煤工尘肺进行PMF(29个病灶)进行CT及MRI扫描,对照分析病灶征象包括肿块部位、形态、大小、边缘特征、内部结构以及邻近胸膜改变等,比较二者对PMF病灶的检出及显示能力。结果 MRI对显示煤工尘肺PMF病灶部位、形态、大小、肿块内部结构及邻近胸膜改变的显示能力与CT比较无明显统计学差异(P>0.05)。CT对显示病灶边缘微细特征及病灶钙化方面优于MRI。病变在MRI T2WI及频谱预饱和反转恢复(SPIR)序列表现为等低不均匀信号,即在等低信号的病灶内可见到斑条状更低信号,具有一定影像特征。结论 MRI可以较好地显示煤工尘肺PMF病灶的大部分征象,病灶信号改变具有特征性,可作为影像学检查的一种有效补充手段,同时对与肺肿瘤的鉴别诊断具有一定帮助。
Objective To evaluate the ability of MRI to display all kinds of signs of progressive massive fibrosis (PMF) in coal worker’s pneumoconiosis and its diagnostic value. Methods Twenty-one cases of coal workers’ pneumoconiosis were diagnosed by CT and MRI scanning. The signs of lesion including tumor location, shape, size, marginal features, internal structure and adjacent pleural changes were compared and analyzed. PMF lesions detection and display capabilities. Results MRI showed no significant difference in the display of PMF lesion location, shape, size, internal structure of the tumor and adjacent pleural changes compared with CT (P> 0.05). CT is superior to MRI in showing fine features at the edge of the lesion and calcification of the lesion. Lesions in the MRI T2WI and spectral pre-saturation inversion recovery (SPIR) sequence showed low-level non-uniform signal, that is, low signal lesions can be seen lower stripes, with a certain image features. Conclusion MRI can display most of the signs of PMF lesions in coal workers’ pneumoconiosis. The signal changes of lesions are characteristic and can be used as an effective supplementary means for imaging examination. At the same time, it is helpful to the differential diagnosis of lung tumors.