Thin-section CT abnormalities and pulmonary gas exchange impairment in workers exposed to asbestos

PURPOSE: To evaluate the relationship between abnormalities at thin-section computed tomography (CT) and indexes of pulmonary gas exchange impairment at rest and during moderate exercise in workers exposed to asbestos. MATERIALS AND METHODS: Eighty-two workers with long-term exposure to asbestos and abnormal thin-section CT findings underwent respiratory physiologic measurements at rest (lung diffusing capacity, DLCO) and during exercise (oxygen uptake-corrected alveolar-arterial pressure difference for oxygen, DeltaP[A-a]O-2/VO2). CT results were compared with physiologic measurements of impairment in gas exchange (DLCO 20 mm Hg (.) L (.) min(-1)). The CT findings were divided into five categories by using a previously described method. Odds ratios and 95% Cls for gas exchange defects were calculated for patients grouped according to CT findings. Logistic regression analysis was performed with gas exchange as the dependent response and CT abnormalities as independent variables. RESULTS: A significant association was found between extent of disease at CT and impairment of gas exchange (P .05). CONCLUSION: Thin-section CT grading of interstitial lung disease is useful in assessing the likelihood of pulmonary gas exchange impairment at rest (DLCO) and during exercise (DeltaP[A-a]O-2/VO2) in workers with long-term asbestos exposure.2321667