High-resolution CT of benign asbestos-related diseases: clinical and radiographic correlation

Department of Radiological Sciences, University of California Los Angeles School of Medicine 90024.

We prospectively analyzed benign asbestos-related pleural and parenchymal abnormalities on high-resolution CT scans and correlated them with clinical diagnoses in 100 asbestos-exposed workers. All subjects had high-resolution CT scans in conjunction with conventional CT at the time of clinical evaluation. To evaluate for asbestosis, we ranked high-resolution CT scans as high, intermediate, or low probability of asbestosis on the basis of the multiplicity and extent of observed parenchymal changes. By linear regression analysis, the most distinctive high-resolution CT features of asbestosis included thickened nondependent interstitial short lines and parenchymal bands. In 45 subjects satisfying clinical criteria of asbestosis, high-resolution CT probability of asbestosis was high in 38 (84%), intermediate in five (11%), and low in two (4%). In 20 (36%) of 55 subjects without clinical asbestosis, parenchymal abnormalities indicative of a high probability of asbestosis were observed on high-resolution CT. High-resolution CT probability scores had a strong positive correlation with chest radiographic profusion scores (p less than .0001) and asbestos-related pleural thickening (p less than .0001). Significant inverse correlations were seen with forced vital capacity (p less than .006) and single-breath diffusing capacity (p less than .03), both functional measures of restrictive interstitial lung disease. Neither clubbing nor rales were sufficiently prevalent to have statistical correlation with high-resolution CT scores. High-resolution CT is sensitive in detecting both pleural and parenchymal abnormalities in the asbestos-exposed subject. Asbestos-related pleural changes are observed more frequently on high-resolution CT than on conventional CT or chest radiography. The probability of asbestosis based on high-resolution CT parenchymal features has a significant correlation with existing clinical determinants of disease, and high-resolution CT can detect abnormality when other methods are not diagnostic.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M. Remy-Jardin, A. Sobaszek, A. Duhamel, I. Mastora, C. Zanetti, and J. Remy Asbestos-related Pleuropulmonary Diseases: Evaluation with Low-Dose Four-Detector Row Spiral CT Radiology, October 1, 2004; 233(1): 182 - 190. [Abstract] [Full Text] [PDF]

				Diagnosis and Initial Management of Nonmalignant Diseases Related to Asbestos Am. J. Respir. Crit. Care Med., September 15, 2004; 170(6): 691 - 715. [Full Text] [PDF]

				A. Sette, J. A. Neder, L. E. Nery, J. Kavakama, R. T. Rodrigues, M. Terra-Filho, S. Guimaraes, E. Bagatin, and N. Muller Thin-Section CT Abnormalities and Pulmonary Gas Exchange Impairment in Workers Exposed to Asbestos Radiology, July 1, 2004; 232(1): 66 - 74. [Abstract] [Full Text] [PDF]

				K. Fujimoto, N. L. Muller, S. Kato, H. Terasaki, J. Sadohara, T. Rikimaru, and N. Hayabuchi Pneumoconiosis in Rush Mat Workers Exposed to Clay Dye "Sendo" Dust: Clinical, Radiologic, and Histopathologic Features in Seven Patients Chest, February 1, 2004; 125(2): 737 - 743. [Abstract] [Full Text] [PDF]

				A Oikonomou and N L Muller Imaging of pneumoconiosis Imaging, March 1, 2003; 15(1): 11 - 22. [Abstract] [Full Text] [PDF]

				H. D. Roach, G. J. Davies, R. Attanoos, M. Crane, H. Adams, and S. Phillips Asbestos: When the Dust Settles—An Imaging Review of Asbestos-related Disease RadioGraphics, October 1, 2002; 22(90001): S167 - 184. [Abstract] [Full Text] [PDF]

				S. J. Copley, A. U. Wells, M. B. Rubens, F. Chabat, R. E. Sheehan, A. W. Musk, and D. M. Hansell Functional Consequences of Pleural Disease Evaluated with Chest Radiography and CT Radiology, July 1, 2001; 220(1): 237 - 243. [Abstract] [Full Text] [PDF]

				H. De Raeve, J.A. Verschakelen, P.A. Gevenois, P. Mahieu, G. Moens, and B. Nemery Observer variation in computed tomography of pleural lesions in subjects exposed to indoor asbestos Eur. Respir. J., May 1, 2001; 17(5): 916 - 921. [Abstract] [Full Text] [PDF]

				J. VAN CLEEMPUT, H. DE RAEVE, J. A. VERSCHAKELEN, J. ROMBOUTS, L. M. LACQUET, and B. NEMERY Surface of Localized Pleural Plaques Quantitated by Computed Tomography Scanning . No Relation with Cumulative Asbestos Exposure and No Effect on Lung Function Am. J. Respir. Crit. Care Med., March 1, 2001; 163(3): 705 - 710. [Abstract] [Full Text] [PDF]

				T. King Idiopathic Pulmonary Fibrosis: Diagnosis and Treatment . International Consensus Statement Am. J. Respir. Crit. Care Med., February 1, 2000; 161(2): 646 - 664. [Full Text]