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Silicosis in 76 Men: Qualitative and Quantitative CT Evaluation—Clinical-Radiologic Correlation Study¹

¹ From the School of Professional and Continuing Education, Dept of Radiology (G.C.O., P.L.K., H.N., I.W.T.H., F.L.C.), Depts of Diagnostic Radiology and Medicine (K.W.T.T., M.S.M.I., W.K.L., M.C.Y.), and Div of Traditional Chinese Medicine (T.F.C.), Univ of Hong Kong, Queen Mary Hosp, F/4, Block K, Pokfulam, Hong Kong SAR, China; and Hong Kong Wanchai Chest Clinic, Dept of Health (C.M.T.). Received May 15, 2002; revision requested Jul 26; final revision received Nov 22; accepted Jan 14, 2003. Supported by a CRCG grant from the Univ of Hong Kong and by the Hong Kong Pneumoconiosis Fund Board. Address correspondence to G.C.O. (e-mail: cgcooi@hkucc.hku.hk).

View larger version (68K): [in a new window]   Figure 1a. Transverse CT scans show nodular profusion grades 1-4. (a) Grade 1 nodular profusion is characterized by a small number of nodules without vascular obliteration; (b) grade 2, by a larger number of nodules with mild vascular obliteration; (c) grade 3, by a large number of nodules with moderate vascular obliteration; and (d) grade 4, by large numbers of nodules with severe vascular obliteration, with or without coalescence (<1.5 cm). In a, the scale on the right represents 5 cm.

View larger version (69K): [in a new window]   Figure 1b. Transverse CT scans show nodular profusion grades 1-4. (a) Grade 1 nodular profusion is characterized by a small number of nodules without vascular obliteration; (b) grade 2, by a larger number of nodules with mild vascular obliteration; (c) grade 3, by a large number of nodules with moderate vascular obliteration; and (d) grade 4, by large numbers of nodules with severe vascular obliteration, with or without coalescence (<1.5 cm). In a, the scale on the right represents 5 cm.

View larger version (68K): [in a new window]   Figure 1c. Transverse CT scans show nodular profusion grades 1-4. (a) Grade 1 nodular profusion is characterized by a small number of nodules without vascular obliteration; (b) grade 2, by a larger number of nodules with mild vascular obliteration; (c) grade 3, by a large number of nodules with moderate vascular obliteration; and (d) grade 4, by large numbers of nodules with severe vascular obliteration, with or without coalescence (<1.5 cm). In a, the scale on the right represents 5 cm.

View larger version (77K): [in a new window]   Figure 1d. Transverse CT scans show nodular profusion grades 1-4. (a) Grade 1 nodular profusion is characterized by a small number of nodules without vascular obliteration; (b) grade 2, by a larger number of nodules with mild vascular obliteration; (c) grade 3, by a large number of nodules with moderate vascular obliteration; and (d) grade 4, by large numbers of nodules with severe vascular obliteration, with or without coalescence (<1.5 cm). In a, the scale on the right represents 5 cm.

View larger version (102K): [in a new window]   Figure 2a. Transverse thin-section CT scans obtained in two men with PMF grades 1-3. (a, b) CT scans obtained in a 65-year-old man show (a) grade 1 PMF in the right middle lung zone (maximum diameter of PMF > 1.5 cm and < 5.0 cm) and (b) grade 2 PMF in the left middle lung zone (maximum diameters of all PMF masses 5 cm but < 10 cm). (c, d) CT scans through the upper lung lobes in a 44-year-old man. The diameters of the PMF masses in the right upper zone are greater than or equal to 10 cm (grade 3). In d, the diameters of the PMF masses in the left upper zone are greater than or equal to 5 cm but less than 10 cm (grade 2).

View larger version (106K): [in a new window]   Figure 2b. Transverse thin-section CT scans obtained in two men with PMF grades 1-3. (a, b) CT scans obtained in a 65-year-old man show (a) grade 1 PMF in the right middle lung zone (maximum diameter of PMF > 1.5 cm and < 5.0 cm) and (b) grade 2 PMF in the left middle lung zone (maximum diameters of all PMF masses 5 cm but < 10 cm). (c, d) CT scans through the upper lung lobes in a 44-year-old man. The diameters of the PMF masses in the right upper zone are greater than or equal to 10 cm (grade 3). In d, the diameters of the PMF masses in the left upper zone are greater than or equal to 5 cm but less than 10 cm (grade 2).

View larger version (60K): [in a new window]   Figure 2c. Transverse thin-section CT scans obtained in two men with PMF grades 1-3. (a, b) CT scans obtained in a 65-year-old man show (a) grade 1 PMF in the right middle lung zone (maximum diameter of PMF > 1.5 cm and < 5.0 cm) and (b) grade 2 PMF in the left middle lung zone (maximum diameters of all PMF masses 5 cm but < 10 cm). (c, d) CT scans through the upper lung lobes in a 44-year-old man. The diameters of the PMF masses in the right upper zone are greater than or equal to 10 cm (grade 3). In d, the diameters of the PMF masses in the left upper zone are greater than or equal to 5 cm but less than 10 cm (grade 2).

View larger version (75K): [in a new window]   Figure 2d. Transverse thin-section CT scans obtained in two men with PMF grades 1-3. (a, b) CT scans obtained in a 65-year-old man show (a) grade 1 PMF in the right middle lung zone (maximum diameter of PMF > 1.5 cm and < 5.0 cm) and (b) grade 2 PMF in the left middle lung zone (maximum diameters of all PMF masses 5 cm but < 10 cm). (c, d) CT scans through the upper lung lobes in a 44-year-old man. The diameters of the PMF masses in the right upper zone are greater than or equal to 10 cm (grade 3). In d, the diameters of the PMF masses in the left upper zone are greater than or equal to 5 cm but less than 10 cm (grade 2).

View larger version (159K): [in a new window]   Figure 3a. Images of the lungs in a 55-year-old man. (a) Chest radiographic findings indicate a diagnosis of simple silicosis. (b) At transverse thin-section CT, however, this patient is shown to actually have grade 2 PMF—that is, complicated silicosis.

View larger version (62K): [in a new window]   Figure 3b. Images of the lungs in a 55-year-old man. (a) Chest radiographic findings indicate a diagnosis of simple silicosis. (b) At transverse thin-section CT, however, this patient is shown to actually have grade 2 PMF—that is, complicated silicosis.

View larger version (18K): [in a new window]   Figure 4a. Graphs show inverse relationships (a) between PMF grade at CT and FEV1/FVC (r = -0.60, P < .001) and (b) between mean lung attenuation and percentage of predicted TLC (r = -0.53, P < .001).

View larger version (23K): [in a new window]   Figure 4b. Graphs show inverse relationships (a) between PMF grade at CT and FEV1/FVC (r = -0.60, P < .001) and (b) between mean lung attenuation and percentage of predicted TLC (r = -0.53, P < .001).