High-resolution CT

This paper reports on high-resolution CT (HRCT) that has been accepted for the imaging of asbestosis, without extensive pathologic correlation. HRCT scans of 28 patients with greater than 5 years of occupational asbestos exposure (in shipyards or construction) were interpreted by two observers blinded to pathologic proof and independently verified in each case. The HRCT scans were obtained before open lung biopsy or death (20 cases) or biopsy of the excised lung (eight cases). The results of the scans were then correlated with the pathologic findings. Asbestosis was present pathologically in 19 cases. In 12 of these 19 patients, the HRCT scan was abnormal, with extensive and characteristic findings sufficient to be considered suggestive of asbestosis. In an additional five cases, the HRCT scan was abnormal but insufficient to be suggestive of asbestosis. In the remaining two patients with the mildest grade of asbestosis, the HRCT scan was normal. In two patients with interstitial lung disease not due to asbestosis (one with organizing pneumonia and one with desquamative interstitial pneumonitis), the HRCT scan would have been misdiagnosed as asbestosis