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Asbestos-related Pleuropulmonary Diseases: Evaluation with Low-Dose Four–Detector Row Spiral CT¹

¹ From the Department of Radiology, Hospital Calmette, University Center of Lille, Boulevard Jules Leclerc, 59037 Lille, France (M.R.J., I.M., C.Z., J.R.); and Environmental and Occupational Health and Ergonomics Research Center (A.S.) and Department of Medical Statistics (A.D.), University of Lille, Lille, France. Received July 23, 2003; revision requested October 3; final revision received February 9, 2004; accepted March 23. Address correspondence to M.R.J. (e-mail: mremy-jardin@chru-lille.fr).

PURPOSE: To evaluate the depiction of lung and pleural asbestos-related lesions with low-dose four–detector row spiral computed tomography (CT).

MATERIALS AND 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.

CONCLUSION: Low-dose multi–detector row spiral CT accurately depicts asbestos-related disease.

© RSNA, 2004

Index terms: Asbestos • Computed tomography (CT), comparative studies, 60.12111, 60.12115, 60.12118 • Lung, CT, 60.12111, 60.12115, 60.12118 • Lung, diseases, 60.742, 60.75, 60.76, 70.773, 60.774 • Pneumoconiosis, 70.773, 60.774

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