目的了解氧化铝致铝尘肺的胸部CT影像特点，提高对氧化铝尘肺影像表现的认识。
方法于2020年8月，回顾性分析2015年4月至2020年7月在淄博市职业病防治院诊断的18例氧化铝尘肺和30例矽肺患者（对照组）的胸部CT表现，比较两种尘肺纤维化的特点，尘肺结节的大小、密度和分布，以及牵拉支气管扩张、胸膜及小叶间隔增厚的发生率。
结果氧化铝尘肺表现为结节伴小叶间隔增厚（66.67%，12/18），伴蜂窝肺（22.22%，4/18）、磨玻璃影（61.11%，11/18），以及单纯结节（11.11%，2/18），无融合团块；对照组表现为结节伴小叶间隔增厚（16.67%，5/30），伴蜂窝肺（6.67%，2/30）、磨玻璃密度影（6.67%，2/30）和融合团块（23.33%，7/30），以及单纯结节（53.33%，16/30）；两组结节伴小叶间隔增厚、磨玻璃密度影、融合团块和单纯结节CT表现差异均有统计学意义（ P<0.05）。18例氧化铝尘肺均见肺间质串珠状结节，其中50.00%（9/18）以串珠状结节为主，低密度结节占61.33%（46/75），38.89%（7/18）可见小叶中央结节，结节宽径为（1.29±0.38）mm；对照组30例矽肺均见小叶中央结节，10.00%（3/30）以串珠状结节为主，低密度结节占36.29%（90/248），结节宽径为（1.85±0.58）mm；两组比较差异均有统计学意义（ P<0.05）。氧化铝尘肺常伴牵拉性支气管扩张、胸膜增厚、小叶间隔增厚（11、18、17例，61.11%、100.00%、94.44%），与对照组（9、18、18例，30.00%、60.00%、60.00%）比较差异均有统计学意义（ P<0.05）。氧化铝尘肺纵隔非钙化淋巴结最大CT值[（103.43±26.33）HU]高于对照组[（75.22±16.70）HU]，差异有统计学意义（ P<0.05）。
结论氧化铝尘肺胸部CT表现为略低密度的串珠结节、小叶间隔增厚、磨玻璃影为主的肺间质纤维化改变，多合并牵拉支气管扩张、胸膜增厚和纵隔淋巴结密度增高。
ObjectiveTo understand the chest CT features of aluminosis caused by alumina and to improve the understanding of the imaging findings of alumina pneumoconiosis.
MethodsThe chest CT findings of 17 cases of alumina-induced pneumoconiosis and 30 cases of silicosis (the control group) diagnosed in Zibo Occupational Disease Prevention Hospital from April 2015 to July 2020 were analyzed retrospectively. The characteristics of fibrosis of the two kinds of pneumoconiosis and the incidence of size, density, distribution, tractive bronchiectasis, pleural thickening and interlobular septal thickening of pneumoconiosis nodules were compared.
ResultsAlumina pneumoconiosis showed nodules with thickened interlobular septal of 66.67% (12/18) , honeycomb lung of 22.22% (4/18) , ground glass shadow of 61.11% (11/18) , simple nodules of 11.11% (2/18) , and no fusion mass. In the control group, the long-line fibrosis of nodules with thickened interlobular septal were 16.67% (5/30) , 6.67% (2/30) with honeycomb lung and ground glass density shadow, 23.33% (7/30) with fusion mass and 53.33% (16/30) with simple nodule. There were significant differences in CT findings of nodules with thickened interlobular septal, ground glass density shadow, fused mass and simple nodules between the two groups ( P<0.05) . The interstitial beaded nodules were seen in 18 cases of alumina pneumoconiosis, 50.00% (9/18) of them were beaded nodules, 61.33% (46/75) of low density nodules and 38.89% (7/18) of central lobular nodules were seen in alumina pneumoconiosis. The average width of nodules was (1.29±0.38) mm. Central lobular nodules were seen in all 30 cases of silicosis, 10.00% (3/30) were mainly beaded nodules, low density nodules were 36.29% (90/248) , and the average width diameter of nodules was (1.85±0.58) mm. There were significant differences between the two groups ( P<0.05) . Alumina pneumoconiosis was often accompanied by traction bronchiectasis, pleural thickening and interlobular septal thickening (11, 18, 17 cases, 61.11%, 100.00%, 94.44%) , compared with the control group (9, 18, 18 cases, 30.00%, 60.00%, 60.00%) . The differences were statistically significant ( P<0.05) . The maximum CT value of noncalcified mediastinal lymphnodes in alumina pneumoconiosis was (103.43±26.33) HU, which was higher than that of the control group[ (75.22±16.70) HU], and the difference was statistically significant ( P<0.05) .
ConclusionAlumina pneumoconiosis chest CT shows slightly low-density beaded nodules, thickened interlobular septal, and pulmonary interstitial fibrosis of ground-glass shadows, mostly combines with stretched bronchiectasis, thickened pleura, and mediastinum increased lymph node density.
王成霞,柳澄,仇路,等. 铝尘肺与矽肺患者胸部CT影像特征的对照研究[J]. 中华劳动卫生职业病杂志,2021,39(07)：534-537.
DOI:10.3760/cma.j.cn121094-20200904-00517版权归中华医学会所有。
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