Noninvasive diagnosis of bronchiolitis obliterans due to sulfur mustard exposure: could high-resolution computed tomography give us a clue?
OBJECTIVE
Previous pathological investigations have reported bronchiolitis obliterans (BO) as the major long-term sequela of exposure to sulfur mustard. In this study, we investigated whether high-resolution computed tomography (HRCT) could be used as a noninvasive imaging modality to differentiate between mustard lung (as a subtype of BO) and other respiratory disorders.


METHODS
Three groups of patients with sulfur-mustard-induced lung injury (BO), severe chronic asthma (resistant asthma) and smoking habit, respectively, were recruited. Also 30 nonsmoking participants were recruited randomly as the control group. Pulmonary function tests (PFT) and HRCT were performed. Images were viewed with a window level of -450 and window width of 1,400 HU. All images were evaluated by an expert radiologist who was blinded regarding the patients' diagnoses and clinical situations.


RESULTS
Airway involvement was higher and more frequent than parenchymal involvement in the groups with chemical-induced injury and asthma in comparison with smokers. On the other hand, parenchymal involvement was more frequent than airway involvement in the smokers' group in comparison with the other groups.


CONCLUSIONS
HRCT can be a very useful method for differentiating between mustard lung, resistant asthma and lung injuries due to cigarette smoking.
Ghanei
M
M
Chemical Injuries Research Center, Baqiyatallah University of Medical Science, Mollasadra Ave, 14359-16471, Tehran, Iran. m.ghanei@bmsu.ac.ir
Ghayumi
M
M
Ahakzani
N
N
Rezvani
O
O
Jafari
M
M
Ani
A
A
Aslani
J
J
D000328:Adult; D001249:Asthma / Q000000981:diagnostic imaging / Q000473:pathology; D001989:Bronchiolitis Obliterans / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D009151:Mustard Gas / Q000506:poisoning*; D012129:Respiratory Function Tests; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed / Q000379:methods*
D009151:Mustard Gas