Norbet Christopher, Joseph Amanda, Rossi Santiago S, Bhalla Sanjeev, Gutierrez Fernando R
Mallinckrodt Institute of Radiology, St. Louis, MO.
Department of Radiology, University of New Mexico, Albuquerque, NM.
Curr Probl Diagn Radiol. 2015 Jul-Aug;44(4):371-82. doi: 10.1067/j.cpradiol.2014.10.002. Epub 2014 Oct 30.
Asbestos exposure can lead to a variety of adverse effects in the thorax. Although currently in the western world, levels of exposure are kept in check by strict regulations, history of previous asbestos exposure continues to have an effect on many, owing to the latent nature of the pathophysiological response of the body to the inhaled fibers. The adverse effects of asbestos generally fall under 3 categories: pleural disease, lung parenchymal disease, and neoplastic disease. Effects on the pleura include pleural effusions, plaques, and diffuse pleural thickening. In the parenchyma, rounded atelectasis, fibrotic bands, and asbestosis are observed. Differentiating asbestosis from other forms of interstitial lung diseases, such as idiopathic pulmonary fibrosis, usual interstitial pneumonia, smoking-related lung disease, and mixed interstitial lung diseases, is important because the prognosis, course of disease, and management of the patient should be tailored based on the specific etiology of the disease. In this review, imaging findings specific to asbestosis are discussed. Finally, exposure to asbestos can lead to neoplastic disease such as pleural mesothelioma, peritoneal mesothelioma, and bronchogenic carcinoma. The purpose of this article is to review the effects of asbestos exposure in the thorax, pathophysiology of these responses, and disease course. Particular emphasis is placed on the radiographic appearance of the disease, discussion of various imaging modalities and their utility, and the role of imaging in the management of patients with previous asbestos exposure and asbestos-related pulmonary disease.
接触石棉可导致胸部出现多种不良反应。尽管目前在西方世界,接触水平通过严格的法规得到控制,但由于人体对吸入纤维的病理生理反应具有潜伏性,既往石棉接触史仍对许多人产生影响。石棉的不良反应通常分为三类:胸膜疾病、肺实质疾病和肿瘤性疾病。对胸膜的影响包括胸腔积液、胸膜斑和弥漫性胸膜增厚。在肺实质中,可观察到圆形肺不张、纤维化带和石棉肺。将石棉肺与其他形式的间质性肺疾病,如特发性肺纤维化、寻常型间质性肺炎、吸烟相关肺病和混合性间质性肺疾病区分开来很重要,因为患者的预后、病程和管理应根据疾病的具体病因进行调整。在这篇综述中,将讨论石棉肺特有的影像学表现。最后,接触石棉可导致肿瘤性疾病,如胸膜间皮瘤、腹膜间皮瘤和支气管癌。本文的目的是综述石棉接触对胸部的影响、这些反应的病理生理学以及疾病病程。特别强调疾病的放射学表现、各种成像模态及其效用的讨论,以及成像在既往接触石棉和石棉相关肺病患者管理中的作用。