Remy-Jardin Martine, Sobaszek Annie, Duhamel Alain, Mastora Ioana, Zanetti Claire, Remy Jacques
Department of Radiology, Hospital Calmette, University Center of Lille, Boulevard Jules Leclerc, 59037 Lille, France.
Radiology. 2004 Oct;233(1):182-90. doi: 10.1148/radiol.2331031133. Epub 2004 Aug 27.
To evaluate the depiction of lung and pleural asbestos-related lesions with low-dose four-detector row spiral computed tomography (CT).
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.
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.
Low-dose multi-detector row spiral CT accurately depicts asbestos-related disease.
评估低剂量四排螺旋计算机断层扫描（CT）对肺部和胸膜石棉相关病变的显示情况。
83名平均职业性接触石棉18年的男性工人接受了CT检查，作为法医调查的一部分。CT检查包括对整个胸部进行低剂量多排螺旋CT扫描，重建层厚为5mm的连续图像，以及薄层CT扫描，后者作为检测胸膜和实质石棉相关异常的参考标准。确定了两组主要异常：（a）胸膜斑和弥漫性胸膜增厚；（b）增厚的间质短线、胸膜下曲线状线、伴有或不伴有支气管扩张的磨玻璃影以及蜂窝状改变。使用McNemar检验比较低剂量多排图像和薄层图像上这些异常的显示频率。
在（a）由胸膜斑组成的壁层胸膜纤维化的显示方面（低剂量CT和薄层CT分别有67例[81%]和65例[78%]工人显示，P = 0.157），低剂量CT图像和薄层CT图像之间未观察到显著差异，胸膜斑主要表现为增厚的、钙化的胸膜线性结构；在（b）实质纤维化特征的显示方面，低剂量CT图像和薄层CT图像之间也未观察到显著差异，实质纤维化由小叶内和小叶间隔线的各种组合（低剂量CT和薄层CT分别有12例[14%]和13例[16%]工人显示，P = 0.564）、胸膜下曲线状线（低剂量CT和薄层CT分别有10例[12%]和8例[10%]工人显示，P = 0.157）以及伴有（低剂量CT和薄层CT分别有6例[7%]和6例[7%]工人显示）或不伴有（低剂量CT和薄层CT分别有5例[6%]和3例[4%]工人显示，P = 0.317）牵拉性支气管扩张的磨玻璃影组成。仅在薄层CT图像上显示出蜂窝状改变（P < 0.001）。肺气肿（低剂量CT和薄层CT分别有26例[31%]和14例[17%]工人显示；P < 0.001）和非钙化结节（低剂量CT有18例[22%]工人显示，薄层CT有1例[1%]工人显示，P < 0.001）在低剂量图像上的显示频率显著高于薄层图像。
低剂量多排螺旋CT能准确显示石棉相关疾病。
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