CT Findings of Silicosis

ABSTRACT

PURPOSE: To describe chest radiographic and CT findings of silicosis, and to compare their findings. MATERIALS AND METHODS: Ten coal miners and six stonemasons were included in this study. All were male and their mean age was 53.1. The mean duration of dust exposure was 15.2 years(range, 5-30 years) in coal miners and 25.3years(range, 15|35 years) in stonemasons. Chest radiographs(n=16), conventional CT scans(n=4), and high resolutionCT(HRCT) scans(n=13) were evaluated. Parenchymal abnormalities were interpreted on the basis of ILO standardfilms(1980) in chest radiographs and on the basis of CAP(College of American Pathologists, 1979) in CT(HRCT)films. RESULTS: Chest radiographs revealed large opacities(n=8), small opacities(n=6), and normal findings(n=2).Type r(n=4) and category 1/1(n=2) were most common for small opacities, while for large opacities, category B(n=4) and category c(n=4) were most common. These small and large opacities were located predominantly in the area of the upper and middle lung. Associated findings were emphysema(n=7), eggshell nodal calcifications(n=3), pneumothorax(n=3), C-P angle blunting(n=4), and pleural thickening(n=1). CT scans revealed micronodules(n=16), nodules(n=3), and progressive massive fibrosis(PMF, n=8). All these lesions were located in the upper and middlelungs, especially in the central portion of the posterior lung. PMF showed diffuse and homogenous(n=3) andpuntate(n=2) calcifications, cavitations(n=5), air bronchograms(n=3), and necrosis(n=1). Peripheral paracicatricalemphysema was associated with PMF(n=8). Other findings were pneumothorax(n=4), emphysema(n=10), hilar andmediastinal nodal enlargement(n=11), bronchial wall thick-enings(n=6), bronchiectasis(n=1), pleuralthickening(n=7), parenchymal fibrosis(n=1), and pulmonary tuberculosis(n=2). CONCLUSION: Small and large opacities in chest radiographs and micronodules, nodules, and PMFs in CT(HRCT) films were located predominately inthe upper and middle lungs, especially in the central portion of the posterior lung in CT films. CT was superiorto plain chest radiographs in the following ways : (1) in the early detection of small opacities, including subpleural micronodules, and in the precise evaluation of their concentration and topography ; (2) in the detection of cavitation or calcification within conglomerate large opacity lesions ; (3) in the detection of hilarand mediastinal nodal enlargements ; and (4) in quantitative assessment of the severity of emphysema.