High Resolution Computed Tomography (HRCT) of Pneumoconioses
Ádám Mester, László Németh*, Ernõ
Makó, Mária Posgay* and Katalin Kiss
Semmelweis University of Medicine, Department of Radiology and Oncotherapy,
Budapest, Hungary
*National Institute of Occupational Health, Department of Radiology,(1)Budapest,
Hungary
Corresponding author: Dr. Ádám Mester, Semmelweis University
of Medicine,
Department of Radiology and Oncotherapy, H-1082 Budapest, Üllõi
út 78/A
Telephone: 36 1 334 3969
Fax number: 36 1 210 0307
E-mail adress: MESTER@RADI.SOTE.HU
CEJOEM 1998, Vol.4. No.2.:114-129
Key words:
HRCT, lung fibrosis, histiocytosis-X, Boeck, pneumoconioses, asbestosis,
silicosis, siderosis, talcosis, hard metal disease
Abbreviations:
CDILD = chronic diffuse interstitial lung disease,
CRY = computed radiography,
CT = computed tomography,
CXR = chest X-ray,
HRCT = High Resolution Computed Tomography,
ILO = International Labour Organisation,
PCT = porphyria cutanea tarda,
TB = tuberculosis
Abstract:
Chest X-ray versus High Resolution Computed Tomography were compared
in 93 workers exposed to dust. HRCT findings versus CXR were different
in 34/93 cases.
HRCT proved light fibrosis (s1/2–s2/1) versus normal CXR in 8/93 cases.
HRCT was normal versus fibrosis (s1/2–s2/1) suggested by CXR in 4/93
cases.
HRCT was normal versus CXR doubtful about fibrosis (s0/1–s1/0) in 11/93
cases.
HRCT was positive about pleural plaques 31/53 asbestos exposed workers
with lung fibrosis while CXR was positive only in 20/53 asbestos exposed
workers, i.e. HRCT was superior versus CXR in 11 cases of pleural plaques.
Authors suggest indications of HRCT:
– after a long exposure to dust at negative CXR with decreased lung
function tests
– if there is a suspicion in a dust exposed patient of other than dust
inhalation aetiology fibrosis, too
– if malignancy is suspected, HRCT and helical contrast CT can help
in diagnosing and staging the lung tumours and pleural diseases as well.
Usual morphology of lung fibrosis induced of whatever reason can change
into unusual morphology after dust exposure. The role of the HRCT in the
complex pneumoconiosis diagnosis offers a possibility for radiologists
to use “smaller holes” for mass screening and categorising as positive
CXR at the screening and/or to explain morphology if lung function tests
found restrictive disorders, but CXR seems to be negative.
Received: 10 February 1998
Accepted: 23 March 1998
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Posted: 15 November 1998