Asbestos-related pleuropulmonary diseases: evaluation with low-dose four-detector row spiral CT.
OBJECTIVE
To evaluate the depiction of lung and pleural asbestos-related lesions with low-dose four-detector row spiral computed tomography (CT).


METHODS
Eighty-three male workers with a mean duration of occupational exposure to asbestos of 18 years underwent CT as part of a medicolegal investigation. CT examination included low-dose multi-detector row spiral CT of the entire thorax, with reconstruction of contiguous 5-mm-thick images, and thin-section CT, which served as the reference standard for the detection of pleural and parenchymal asbestos-related abnormalities. Two main groups of abnormalities were identified: (a) pleural plaques and diffuse pleural thickening and (b) thickened interstitial short lines, curvilinear subpleural lines, ground-glass opacity with or without bronchiectasis, and honeycombing. The frequencies of the depiction of these abnormalities on the low-dose multi-detector row images and the thin-section images were compared by using the McNemar test.


RESULTS
No significant differences were observed between the low-dose and thin-section CT images in the depiction of either (a) parietal pleural fibrosis consisting of pleural plaques (identified in 67 [81%] vs 65 [78%] workers, P =.157), which appeared mainly as thick, calcified pleural linear structures; or (b) features of parenchymal fibrosis, which consisted of various combinations of intralobular and septal lines (identified in 12 [14%] vs 13 [16%] workers, P =.564), subpleural curvilinear lines (identified in 10 [12%] vs eight [10%] workers, P =.157), and ground-glass opacity with (identified in six [7%] vs six [7%] workers) or without (identified in five [6%] vs three [4%] workers, P =.317) traction bronchiectasis. A honeycombing pattern was depicted on only the thin-section CT images (P <.001). Emphysema (identified in 26 [31%] vs 14 [17%] workers at low-dose and thin-section CT, respectively; P <.001) and noncalcified nodules (identified in 18 [22%] workers vs one [1%] worker, P <.001) were depicted significantly more frequently on the low-dose images than on the thin-section images.


CONCLUSIONS
Low-dose multi-detector row spiral CT accurately depicts asbestos-related disease.
Remy-Jardin
Martine
M
Department of Radiology, Hospital Calmette, University Center of Lille, Boulevard Jules Leclerc, 59037 Lille, France. mremy-jardin@chru-lille.fr
Sobaszek
Annie
A
Duhamel
Alain
A
Mastora
Ioana
I
Zanetti
Claire
C
Remy
Jacques
J
D000368:Aged; D000369:Aged, 80 and over; D001195:Asbestosis / Q000000981:diagnostic imaging*; D001987:Bronchiectasis / Q000000981:diagnostic imaging; D005355:Fibrosis; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D010994:Pleura / Q000000981:diagnostic imaging; D010995:Pleural Diseases / Q000000981:diagnostic imaging*; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging; D011829:Radiation Dosage; D036542:Tomography, Spiral Computed / Q000379:methods*