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J Korean Soc Radiol. 2014 Jun;70(6):423-429. Korean. Original Article.
Lee SJ , Kim SJ , Hyun SJ , Kang MH , Yi KS , Chun KA , Zhang Y , Lee WJ , Choi BS .
Department of Diagnostic Radiology, College of Medicine, Chungbuk National University, Cheongju, Korea.
Occupational Lung Diseases Institute, COMWEL, Ansan, Korea.

PURPOSE: We describe high-resolution computed tomographic (HRCT) findings in type p pneumoconiosis. MATERIALS AND METHODS: In total, 147 patients who were confirmed with pneumoconiosis on chest radiographs then underwent HRCT; 38 patients with p-nodules on chest radiographs constituted the study population. Chest CT findings, such as the appearance of the p-nodules (ill-defined small nodules, bi-branching structure, well-marginated micronodule, tree-in-bud appearance), the presence of subpleural nodules, changes in the bronchus (e.g., thickening of the bronchial wall, bronchiectasis), and presence of emphysema (centrilobular, perinodular) were reviewed retrospectively by two radiologists in consensus. RESULTS: In the 38 patients, two did not have nodules, just emphysema. The majority of the p-nodules in the other 36 patients were located in the upper and middle lung fields (n = 33, 91.7%). The most common HRCT findings of p-nodules were ill-defined small nodules, larger than 1.5 mm, and with bi-branching structures (32/36, 88.9%). Well-marginated micronodules were also common (27/36, 75.0%); however, the tree-in-bud appearance was rare (4/36, 11.1%). Changes in the bronchus [thickening of the bronchial wall (27/36, 75.0%), bronchiectasis (19/36, 52.8%)] were identified in 29 patients (80.6%). Centrilobular emphysema and perinodular emphysema were seen in 19 (52.8%) and 9 (25.0%) patients, respectively. All of the patients with perinodular emphysema also had centrilobular emphysema. Subpleural nodules were identified in 17 patients (47.2%). CONCLUSION: The distribution of p-nodules was predominantly upper and middle. The most common HRCT findings of p-nodules were ill-defined small nodules and bi-branching structures. Additional useful findings are well-marginated micronodules and changes in the bronchus, such as thickening of the bronchial wall and bronchiectasis.

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