1.The profusion evaluation method for irregular small opacities associated with pneumoconiosis in chest CT
Qiang WANG ; Jing BAI ; Luyan GE ; Ningning ZHANG ; Lijing ZHANG ; Fei KANG ; Huitai DONG
China Occupational Medicine 2024;51(6):650-655
Objective To explore a method for assessing the irregular small opacities profusion associated with occupational pneumoconiosis in chest computed tomography (CT). Methods A total of 20 occupational pneumoconiosis patients whose primary manifestation was irregular small opacities on chest digital radiography (DR) were collected as the research subjects using a retrospective study method. Comparative analysis was performed between chest DR and five mm coronal multi-planar reconstruction (MPR) of chest CT images to identify the causes of irregular small opacities. An evaluation method for the profusion of associated images of irregular small opacities in chest CT was established using technique for order preference by similarity to ideal solution-analytic hierarchy process (TOPSIS-AHP), and the results were compared against GBZ 70-2015 Diagnosis of Occupational Pneumoconiosis. Results The abnormal image distribution on the five mm coronal chest CT MPR images of the 20 patients was as follows: three cases of high-density small circular opacities, seven cases of low-density circular small opacities, six cases of diffuse low-density ground-glass opacities (GGO), four cases of reticular opacities, three cases of plate-like GGO, three cases of honeycomb opacities, and four cases of increasing lung texture. The CT values of abnormal images, from high to low were: honeycomb opacities > plate-like GGO > low-density circular small opacities > diffuse low-density GGO (all P<0.05). The consistency test results indicated that the evaluation method for the profusion of associated images of irregular small opacities in chest CT showed high level of agreement with the profusion determination criteria outlined in GBZ 70-2015 Diagnosis of Occupational Pneumoconiosis (Kappa=0.78). Conclusion Irregular small opacities observed on chest DR are formed by the superposition of multiple images of abnormal pulmonary fibrosis in patients with occupational pneumoconiosis. TOPSIS-AHP can be used to establish an evaluation method of the profusion of associated image of irregular small opacity in chest CT.
2.Study on evaluation method of circular small shadow profusion in chest CT reconstruction images of pneumoconiosis
Chang LIU ; Ming YANG ; Qiang WANG ; Jing BAI ; Zheng DUAN ; Huitai DONG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2024;42(5):359-369
Objective:To select chest CT image patterns for the diagnosis of pneumoconiosis and establish a method for determining the profusion of circular small shadows in chest CT.Methods:In April 2021, 66 cases of occupational pneumoconiosis patients with digital radiography (DR) chest radiographs and chest CT imaging data with circular small shadow as the main manifestations were selected as the study objects. 1.5 mm and 5 mm chest CT axial images, 1 mm and 5 mm chest CT coronal multi-plane recombination (MPR) images, and 5 mm chest CT coronal maximum intensity projection (MIP) images were used to observe the different characteristics of pneumoconiosis patients, and were compared and analyzed with DR chest radiographs to establish the experimental chest CT standards. The consistency of the profusion results between the experimental chest CT standards and GBZ 70-2015 Diagnosis of Occupational Pneumoconiosis was verified.Results:All the 66 objects were male, including 33 cases of stage Ⅰ pneumoconiosis, 17 cases of stage Ⅱ pneumoconiosis and 16 cases of stage Ⅲ pneumoconiosis. By observing five chest CT images of 66 objects, we found that chest CT images of different modes could clearly display and identify abnormal images such as small circular shadow, large shadow, small shadow aggregation, honeycomb glass shadow, flake glass shadow, uniform low-profusion glass shadow, mesh glass shadow, cable shadow, linear shadow, subpleural spinous shadow, subpleural nodules, various kinds of emphysema and lung texture distortion and fracture. Small shadow aggregation was usually accompanied by the appearance of large shadow. The vascular shadows in 5 mm CT images had good ductility, and small nodules were easy to distinguish. The coronal MIP image of 5 mm chest CT used edge enhancement technology, which was prone to small shadow fusion and fibrotic shadow fusion. The coronal MPR image of 5 mm chest CT was highly consistent with the DR chest radiographs in terms of the integrity of film reading. GBZ 70-2015 standard was used to compare the profusion of DR chest radiographs and 5 mm chest CT coronal MPR images of 66 objects, and the consistency test Kappa=0.64. GBZ 70-2015 standard and experimental chest CT standard were used to compare the profusion results of DR chest radiographs and 5 mm chest CT coronal MPR images of 66 objects, respectively, and the consistency test Kappa=0.80, with high consistency.Conclusion:5 mm coronal MPR image is suitable for chest CT imaging in the diagnosis of pneumoconiosis. Following the selection path and method of GBZ 70-2015 profusion criterion, the established experimental chest CT standard in determining the profusion of small circular shadows in 5 mm coronal MPR images of chest CT with pneumoconiosis has a high consistency with GBZ 70-2015 standard.
3.Study on evaluation method of circular small shadow profusion in chest CT reconstruction images of pneumoconiosis
Chang LIU ; Ming YANG ; Qiang WANG ; Jing BAI ; Zheng DUAN ; Huitai DONG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2024;42(5):359-369
Objective:To select chest CT image patterns for the diagnosis of pneumoconiosis and establish a method for determining the profusion of circular small shadows in chest CT.Methods:In April 2021, 66 cases of occupational pneumoconiosis patients with digital radiography (DR) chest radiographs and chest CT imaging data with circular small shadow as the main manifestations were selected as the study objects. 1.5 mm and 5 mm chest CT axial images, 1 mm and 5 mm chest CT coronal multi-plane recombination (MPR) images, and 5 mm chest CT coronal maximum intensity projection (MIP) images were used to observe the different characteristics of pneumoconiosis patients, and were compared and analyzed with DR chest radiographs to establish the experimental chest CT standards. The consistency of the profusion results between the experimental chest CT standards and GBZ 70-2015 Diagnosis of Occupational Pneumoconiosis was verified.Results:All the 66 objects were male, including 33 cases of stage Ⅰ pneumoconiosis, 17 cases of stage Ⅱ pneumoconiosis and 16 cases of stage Ⅲ pneumoconiosis. By observing five chest CT images of 66 objects, we found that chest CT images of different modes could clearly display and identify abnormal images such as small circular shadow, large shadow, small shadow aggregation, honeycomb glass shadow, flake glass shadow, uniform low-profusion glass shadow, mesh glass shadow, cable shadow, linear shadow, subpleural spinous shadow, subpleural nodules, various kinds of emphysema and lung texture distortion and fracture. Small shadow aggregation was usually accompanied by the appearance of large shadow. The vascular shadows in 5 mm CT images had good ductility, and small nodules were easy to distinguish. The coronal MIP image of 5 mm chest CT used edge enhancement technology, which was prone to small shadow fusion and fibrotic shadow fusion. The coronal MPR image of 5 mm chest CT was highly consistent with the DR chest radiographs in terms of the integrity of film reading. GBZ 70-2015 standard was used to compare the profusion of DR chest radiographs and 5 mm chest CT coronal MPR images of 66 objects, and the consistency test Kappa=0.64. GBZ 70-2015 standard and experimental chest CT standard were used to compare the profusion results of DR chest radiographs and 5 mm chest CT coronal MPR images of 66 objects, respectively, and the consistency test Kappa=0.80, with high consistency.Conclusion:5 mm coronal MPR image is suitable for chest CT imaging in the diagnosis of pneumoconiosis. Following the selection path and method of GBZ 70-2015 profusion criterion, the established experimental chest CT standard in determining the profusion of small circular shadows in 5 mm coronal MPR images of chest CT with pneumoconiosis has a high consistency with GBZ 70-2015 standard.