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Silicosis: expiratory thin-section CT assessment of airway obstruction Arakawa H; Gevenois PA; Saito Y; Shida H; De Maertelaer V; Morikubo H; Fujioka MRadiology 2005[Sep]; 236 (3): 1059-66PURPOSE: To prospectively evaluate if findings on paired inspiratory and expiratory thin-section computed tomographic (CT) scans in patients with silicosis correlate with pulmonary function test results. MATERIALS AND METHODS: Institutional review board approval and patient consent were obtained. Thirty-seven men (mean age, 71 years; range, 53-88 years) with silicosis were included. All patients had undergone inspiratory and expiratory thin-section CT and spirometry. Silicotic nodules, large opacity, emphysema, reticular opacities, bronchiectasis, and air trapping were graded subjectively on CT images. Emphysema was quantified on these images with built-in software. CT numbers were correlated with spirometric findings by using Spearman rank correlation analyses. Ten healthy volunteers (three men and seven women; mean age, 58 years) served as control subjects. RESULTS: After exclusion of three patients with inadequate image quality, 34 patients (mean age, 70 years; range, 53-88 years) were enrolled in the study group. Spirometric values did not differ significantly between patients with simple (n = 20) and patients with complicated (n = 14) silicosis but were significantly lower in patients than in control subjects. CT findings included air trapping (n = 33), emphysema (n = 26), nodules (n = 32), bronchiectasis (n = 22), large opacity (n = 19), and reticulation (n = 5). The extent of both air trapping and emphysema correlated negatively with spirometric values; the air trapping score showed the strongest correlation (ratio of forced expiratory volume in 1 second to forced vital capacity [FVC]: rho = -0.632, P < .001; forced expiratory flow at 50% of the FVC: rho = -0.576, P = .001). Silicotic nodule, large opacity, and bronchiectasis scores did not correlate with obstructive functional impairments. CONCLUSION: In comparison with the spirometric value, the extent of air trapping proved the best CT index in the assessment of obstructive derangement in workers with exposure to silica dust.|Aged[MESH]|Aged, 80 and over[MESH]|Airway Obstruction/*diagnostic imaging[MESH]|Case-Control Studies[MESH]|Dust[MESH]|Female[MESH]|Humans[MESH]|Image Processing, Computer-Assisted[MESH]|Male[MESH]|Middle Aged[MESH]|Prospective Studies[MESH]|Respiratory Function Tests[MESH]|Silicosis/*diagnostic imaging/etiology[MESH]|Tomography, X-Ray Computed/*methods[MESH] |
