Comparison of the efficacy of spiral CT combined with advanced multiplanar reconstruction in detecting the progression of pneumoconiosis.

OBJECTIVE

To investigate the value of multiplanar reconstruction (MPR) technology in the quantitative analysis of bronchovascular bundle (BVB) for staging pneumoconiosis.

METHODS

We retrospectively analyzed CT data from 65 patients with confirmed pneumoconiosis (42 stage I, 16 stage II, 7 stage III) at Hefei Third People's Hospital between January 2020 and March 2025. MPR was used to measure the bronchial wall thickness-to-diameter ratio (WT/D), the vascular bifurcation angle variation index (AVI), and the peribronchial fractal dimension (FD). Feature parameters were selected using Lasso regression, and diagnostic efficacy was evaluated using ROC curves.

RESULTS

Significant intergroup differences were observed: the stage III group showed significantly higher WT/D, AVI, and FD values than the stage I group (p < 0.001). The positivity rate for the cuffing sign was higher in the stage II group compared to the stage I group (p = 0.003). The combined parameters (WT/D + AVI + FD) achieved an AUC of 0.911, with a sensitivity of 92.3% and specificity of 88.6%, outperforming individual parameters (p = 0.002). AVI positively correlated with the vascular calcification score (p < 0.001), while FD negatively correlated with lung volume (p = 0.001). The interobserver intraclass correlation coefficient (ICC) for WT/D measurements reached 0.923, and the diagnostic concordance rate for stage III was 100%.

CONCLUSION

MPR technology can quantify structural distortions of the BVB in pneumoconiosis. The combined parameter model provides an objective imaging basis for the clinical staging of pneumoconiosis.