Estudo Comparativo da Tomografia Computadorizada de Alta Resolução com a Radiografia de Tórax na Silicose

Abstract

The diagnosis of silicosis is based on the history of exposure to silica dust associated with the radiological alterations compatible with the disease. With the main objective of comparing the alterations found in the chest radiography to those of high resolution computed tomography 49 patients with silicosis were selected. These imaging methods were evaluated separately by three readers and the results summarized through the median of the readings. The following alterations were analysed: nodules, coalescences, large opacities, lynfadenopathy. The patients were male, at an average age of 47.1 years, the majority being sandblasters, with an average exposure time to dust of 15.3 years. When the chest radiography was compared to high resolution computed tomography the following alterations were observed: i) the high resolution computed tomography showed greater profusion of nodules in 19 cases; ii) the high resolution computed tomography detected isolated coalescence and large opacities in 28 cases, seven of them who were classified initially as having simple silicosis were later changed to the complicated form; iii) the high resolution computed tomography was superior in the evaluation of lynfadenopathy in 16 cases. So, from the 49 analysed patients the high resolution computed tomography was more sensitive than the chest radiography in the evaluation of the alterations studied in 38 (77,5%) cases. Other alterations such as cavities, pleural thickening and emphysema were also observed only by this method in 5 cases. In the last 6 (12,2%) cases the high resolution computed tomography did not add any data when compared to chest radiography, four of these showed the initial form of the disease.

Fibrose maciça progressiva em trabalhadores expostos à sílica: achados na tomografia computadorizada de alta resolução

“…Some authors (20) have described sparse calcifications within silicosis-related PMF masses, whereas others (21) have reported lymph node calcification in 26 of 49 silicosis cases studied, 12.2% being of the eggshell type, which was found to be much more frequent in accelerated silicosis than in the simple nodular form.…”

Comparison of the International Classification of High-resolution Computed Tomography for occupational and environmental respiratory diseases with the International Labor Organization International Classification of Radiographs of Pneumoconiosis

“…The superiority of using HRCT to chest x-rays in detecting large opacities and emphysema has been demonstrated in many studies15, 25, 26 ) . In our study, more emphysema was detected statistically using HRCT.…”

Existe Diferença Na Função Pulmonar Entre Pacientes Com Silicose Simples E Complicada?

“…O padrão radiológico de pequenas opacidades com diâmetro inferior a 1,0 cm é comumente referido como silicose simples (de Castro et al, 2014;Krefft et al, 2020;Marchiori et al, 2006). A confluência dos nódulos pode evoluir para a forma complicada da doença, caracterizada por opacidades com mais de 1,0 cm de diâmetro, sendo, desta forma, denominada de silicose complicada, ou também de fibrose maciça progressiva (Castro et al, 2022;de Castro et al, 2014;Greenberg et al, 2007;Marchiori et al, 2006;Moreira et al, 2003;Shipley, 1992).…”