Silicosis CT
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Silicosis CT On the Web |
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American Roentgen Ray Society Images of Silicosis CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
- High resolution computed tomography (HRCT) is helpful for patients with an atypical clinical presentation or atypical findings on chest radiograph. A baseline HRCT scan in patients with radiographic findings of silicosis is usually obtained to document the presence and extent of nodules, emphysema, and other silica-related abnormalities that may progress in the future.
Computed Tomography scan
- A CT scan can also provide a mode detailed analyses of the nodules, and can reveal cavitation due to concomitant mycobacterial infection.
However, HRCT is usually not necessary in simple silicosis unless atypical clinical or radiographic features are noted (eg, fever, spiculated nodules, a single nodule of substantially larger size than the others)[74,75]. The typical HRCT findings in simple silicosis are bilateral, symmetric, centrilobular, and perilymphatic nodules with sharp margination (image 5). These nodules calcify in 10 to 20 percent of patients.
- In complicated silicosis HRCT is superior to conventional chest radiography for documentation of conglomerate lesions and emphysematous changes. The HRCT findings consist of numerous bilateral centrilobular nodular opacities, focal ground glass opacities, and patchy areas of consolidation [54]. Hilar lymph node enlargement may be apparent on HRCT, which is a typical feature of silicosis, but not of PAP [53].In a small series that compared pulmonary alveolar proteinosis (PAP) and acute silicosis, the most common HRCT finding in PAP was “crazy paving”, while the most common finding in acute silicosis was dependent consolidation and nodular calcification [55].
- Although pleural effusions are unusual in silicosis, pleural thickening appears to be common among patients with more severe disease.[79].