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
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

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