"Chest X-ray versus High Resolution Computed Tomography were compared in 93 workers exposed to dust. HRCT findings versus CXR were different in 34/93 cases.
HRCT proved light fibrosis (s1/2–s2/1) versus normal CXR in 8/93 cases.
HRCT was normal versus fibrosis (s1/2–s2/1) suggested by CXR in 4/93 cases.
HRCT was normal versus CXR doubtful about fibrosis (s0/1–s1/0) in 11/93 cases.
HRCT was positive about pleural plaques 31/53 asbestos exposed workers with lung fibrosis while CXR was positive only in 20/53 asbestos exposed workers, i.e. HRCT was superior versus CXR in 11 cases of pleural plaques.
Authors suggest indications of HRCT:
– after a long exposure to dust at negative CXR with decreased lung function tests
– if there is a suspicion in a dust exposed patient of other than dust inhalation aetiology fibrosis, too
– if malignancy is suspected, HRCT and helical contrast CT can help in diagnosing and staging the lung tumours and pleural diseases as well.
Usual morphology of lung fibrosis induced of whatever reason can change into unusual morphology after dust exposure. The role of the HRCT in the complex pneumoconiosis diagnosis offers a possibility for radiologists to use “smaller holes” for mass screening and categorising as positive CXR at the screening and/or to explain morphology if lung function tests found restrictive disorders, but CXR seems to be negative. "

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