Department of Radiology, Behavioral Sciences Department, University of Chicago, Chicago, IL, USA.
Department of Radiology, Cardiopulmonary Imaging, University of Chicago, Chicago, IL, USA.
Korean J Radiol. 2023 Aug;24(8):795-806. doi: 10.3348/kjr.2023.0274.
Occupational lung diseases (OLD) are a group of preventable conditions caused by noxious inhalation exposure in the workplace. Workers in various industries are at a higher risk of developing OLD. Despite regulations contributing to a decreased incidence, OLD remain among the most frequently diagnosed work-related conditions, contributing to significant morbidity and mortality. A multidisciplinary discussion (MDD) is necessary for a timely diagnosis. Imaging, particularly computed tomography, plays a central role in diagnosing OLD and excluding other inhalational lung diseases. OLD can be broadly classified into fibrotic and non-fibrotic forms. Imaging reflects variable degrees of inflammation and fibrosis involving the airways, parenchyma, and pleura. Common manifestations include classical pneumoconioses, chronic granulomatous diseases (CGD), and small and large airway diseases. Imaging is influenced by the type of inciting exposure. The findings of airway disease may be subtle or solely uncovered upon expiration. High-resolution chest CT, including expiratory-phase imaging, should be performed in all patients with suspected OLD. Radiologists should familiarize themselves with these imaging features to improve diagnostic accuracy.
职业性肺部疾病(OLD)是一组可预防的疾病,由工作场所吸入有害物质引起。从事各种行业的工人患 OLD 的风险更高。尽管法规的实施降低了 OLD 的发病率,但它仍然是最常见的职业病之一,导致了相当高的发病率和死亡率。及时诊断需要多学科讨论(MDD)。影像学,特别是计算机断层扫描,在诊断 OLD 和排除其他吸入性肺部疾病方面起着核心作用。OLD 可以大致分为纤维化和非纤维化形式。影像学反映了气道、实质和胸膜的炎症和纤维化程度不同。常见表现包括经典尘肺、慢性肉芽肿性疾病(CGD)和小气道和大气道疾病。影像学受激发暴露的类型影响。气道疾病的表现可能很细微,或者仅在呼气时才会显现。所有疑似 OLD 的患者均应进行高分辨率胸部 CT 检查,包括呼气期成像。放射科医生应熟悉这些影像学特征,以提高诊断准确性。