Restrictive lung function and asbestos-induced pleural fibrosis. A quantitative approach.
To assess further the clinical significance of asbestos-induced pleural fibrosis, we used a computer algorithm to reconstruct images three dimensionally from the high-resolution computerized tomography (HRCT) scan of the chest in 60 asbestos-exposed subjects. Pulmonary function tests, chest radiographs, and HRCT scans were performed on all study subjects. The volume of asbestos-induced pleural fibrosis was computed from the three-dimensional reconstruction of the HRCT scan. Among those with pleural fibrosis identified on the HRCT scan (n = 29), the volume of the pleural lesion varied from 0.01% (0.5 ml) and 7.11% (260.4 ml) of the total chest cavity. To investigate the relationship between asbestos-induced pleural fibrosis and restrictive lung function, we compared the computer-derived estimate of pleural fibrosis to the total lung capacity and found that these measures were inversely related (r = -0.40; P = 0.002). After controlling for age, height, pack-years of cigarette smoking, and the presence of interstitial fibrosis on the chest radiograph, the volume of pleural fibrosis identified on the three-dimensional reconstructed image from the HRCT scan was inversely associated with the total lung capacity (P = 0.03) and independently accounted for 9.5% of the variance of this measure of lung volume. These findings further extend the scientific data supporting an independent association between pleural fibrosis and restrictive lung function.
Department of Internal Medicine, University of Iowa, Iowa City.
D A
DA
Schwartz
J R
JR
Galvin
S J
SJ
Yagla
S B
SB
Speakman
J A
JA
Merchant
G W
GW
Hunninghake
D000368:Aged; D001194:Asbestos / Q000009:adverse effects*; D001195:Asbestosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D005355:Fibrosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D010995:Pleural Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012907:Smoking; D014057:Tomography, X-Ray Computed; D014109:Total Lung Capacity
D001194:Asbestos