High-resolution computed tomography (CT) was performed in 20 patients with diffuse panbronchiolitis. Images of abnormal peripheral lung were classified into four types: small nodules around the end of bronchovascular branchings (CT type I), small nodules in the centrilobular area connected with small branching linear opacities (CT type II), nodules accompanied by ring-shaped or small ductal opacities connected to proximal bronchovascular bundles (CT type III), large cystic opacities accompanied by dilated proximal bronchi (CT type IV). CT classifications were compared with radiographic classifications and clinical stages of the disease. The comparison revealed that the classification based on CT findings reflected the clinical stages and pathologic process of diffuse panbronchiolitis. The authors conclude that high-resolution CT is useful in the evaluation of both the location and severity of the lesions.
To determine the earliest stage at which lesions in asbestosis can be diagnosed and to assess their progression, 23 asbestos-exposed patients with minimal or no abnormalities at plain radiography were examined with high-resolution computed tomography (HRCT) twice, with an interval of 12-37 months between examinations. In 21 of the patients, parenchymal abnormalities were found. Major parenchymal features seen at CT included thickened intralobular and interlobular lines, subpleural curvilinear lines, pleural-based nodular irregularities, hazy patches of increased attenuation, small cystic spaces, and small areas of low attenuation. At paired serial CT, subpleural isolated dots or branching structures connected with the most peripheral branch of the pulmonary artery started to appear in lower subpleural zones and then became confluent to create pleural-based nodular irregularities. CT-pathologic correlation led to the conclusion that the confluence of subpleural peribronchiolar fibrosis creates subpleural fibrosis.
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