High-resolution CT in chronic pulmonary changes after mustard gas exposure.
OBJECTIVE
To identify the findings of high-resolution CT (HRCT) of the lung in patients with previous sulfur mustard gas exposure, and to correlate these findings with clinical and chest X-ray (CXR) results.


METHODS
50 consecutive patients were studied prospectively. The clinical data were recorded. Standard p.a. CXR and HRCT of the lung and spirometry were performed. The findings of CXR, HRCT and clinical and spirometry results were scored between 0 and 3 according to the severity of the findings.


RESULTS
HRCT abnormality was detected in all 50 patients (100%), while CXR was abnormal in 40 patients (80%). The most common HRCT findings was airway abnormalities (bronchial wall thickening in 100% of cases). Other important findings were suggestive of interstitial lung disease (ILD) (80%), bronchiectasis (26%), and emphysema (24%). A statistically significant correlation was found between the severity of clinical presentation and that of the HCTR scores in patients with bronchiectasis, bronchitis and ILD (p< 0.05), but not with severity scores of HRCT in patients with emphysema. No significant correlation was found between severity scores of CXR findings. HRCT evidence of bronchial wall thickening and with a lower frequency ILD were present despite normal CXR in 20% of the patients.


CONCLUSIONS
The results of this study suggest that bronchial wall thickening, ILD and emphysema are common chronic pulmonary sequelae of sulfur mustard injury. HRCT of the chest should be considered as the imaging modality of choice in chemical war injury.
Bagheri
M H
MH
Department of Radiology, Medical School, Shiraz University of Medical Siences, Iran. bagherih@sums.ac.ir
Hosseini
S K
SK
Mostafavi
S H
SH
Alavi
S A
SA
D000328:Adult; D001987:Bronchiectasis / Q000000981:diagnostic imaging / Q000209:etiology; D001991:Bronchitis / Q000000981:diagnostic imaging / Q000209:etiology; D002618:Chemical Warfare; D002619:Chemical Warfare Agents / Q000009:adverse effects*; D006801:Humans; D007492:Iran; D007493:Iraq; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D009151:Mustard Gas / Q000009:adverse effects*; D011446:Prospective Studies; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014857:Warfare
D002619:Chemical Warfare Agents; D009151:Mustard Gas