Early asbestosis: evaluation with high-resolution CT.

Abstract

To determine the earliest stage at which lesions in asbestosis can be diagnosed and to assess their progression, 23 asbestos-exposed patients with minimal or no abnormalities at plain radiography were examined with high-resolution computed tomography (HRCT) twice, with an interval of 12-37 months between examinations. In 21 of the patients, parenchymal abnormalities were found. Major parenchymal features seen at CT included thickened intralobular and interlobular lines, subpleural curvilinear lines, pleural-based nodular irregularities, hazy patches of increased attenuation, small cystic spaces, and small areas of low attenuation. At paired serial CT, subpleural isolated dots or branching structures connected with the most peripheral branch of the pulmonary artery started to appear in lower subpleural zones and then became confluent to create pleural-based nodular irregularities. CT-pathologic correlation led to the conclusion that the confluence of subpleural peribronchiolar fibrosis creates subpleural fibrosis.

Small airways diseases: detection and insights with computed tomography

“…However, when dust-exposed individuals are compared to matched nondust-exposed smoking control subjects, the degree of fibrosis around the terminal bronchioles is considerably greater in dustexposed individuals [50]. In the specific case of asbestos exposure, the earliest phases of asbestosinduced pulmonary damage is peribronchiolar fibrosis and this lesion can be identified on HRCT images as minute irregular centrilobular nodules [51]. Whether other CT signs of constrictive bronchiolitis, notably air-trapping on expiratory CT, occur with any frequency in inorganic dust-induced pulmonary disease has not been reported.…”

High-resolution computed tomography classification of lung fibrosis for patients with asbestos-related disease

“…The patients were then classified into 6 categories by their main occupation and numbered according to estimated increasing asbestos exposure (figure 1, groups [3][4][5][6][7][8]. All the enrolled patients were construction workers who had installed heat and fire insulation, walls, and ceiling panels containing asbestos or had used asbestos paints, putties, and fillers.…”

“…Since the late 1980s, computed tomography (CT) and especially thin-section high-resolution CT (HRCT) have proved to be much more sensitive in detecting asbestos-induced pleural and parenchymal changes in their early stages (6)(7)(8)(9)(10)(11), even before clinical signs are present (12)(13)(14). With the new technologies it may be difficult to separate between subnormal radiological findings that can occur in a normal elderly population and the significant ones possibly due occupational exposure.…”

A Patient with Asbestos-Induced Lung Cancer Complicated by Silicosis.

“…This suggestion has been supported by Egilman 11) and Hillerdal 9) in the 1990s. Indeed, in this patient with pulmonary asbestosis, a definite diagnosis of pulmonary asbestosis could not be made though chest CT scanning showed subpleural curvilinear shadows 16) . Pleural plaques are readily diagnosed by chest CT at present.…”