Imaging Diagnosis of Asbestosis

ABSTRACT

Asbestosis is diffuse interstitial pulmonary fibrosis associated with asbestos fiber inhalation. The typical chest radiographic findings in asbestosis are small irregular or reticular opacities, predominating at the lung bases. Honeycombing is evident in more advanced diseases. But chest radiograph is relatively insensitive in detecting the presence of asbestosis. HRCT is more sensitive than simple chest radiograph for diagnosis of asbestosis, especially the early change of asbestosis. The early findings of asbestosis on HRCT are subpleural dotlike opacities and curvilinear opacities. As progression of fibrosis, intralobular interstitial thickening and interlobular septal thickening are presented. In advanced diseases, parenchymal bands, traction bronchiectasis or bronchiolectasis, and honeycombing are noted. These findings are typically located in lower posterior subpleural portions with bilateral symmetric patterns. Imaging findings that are compatible with asbestosis, rale, and a reduced diffusing capacity can increase confidence of diagnosis of asbestosis.