OBJECTIVES: Cigarette smoking-induced airway disease commonly results in an overall increase of non-specific lung markings on chest radiography. This has been described as "dirty chest". As the morphological substrate of this condition is similar to the anthracosilicosis of coal workers, we hypothesised that it is possible to quantify the radiological changes using the International Labour Organization (ILO) classification of pneumoconiosis. The aims of this study were to evaluate whether there is a correlation between the extent of cigarette smoking and increased lung markings on chest radiography and to correlate the chest radiographic scores with findings on CT studies. METHODS: In a prospective analysis a cohort of 85 smokers was examined. The cigarette consumption was evaluated in pack years (defined as 20 cigarettes per day over 1 year). Film reading was performed by two board-certified radiologists. Chest radiographs were evaluated for the presence of thickening of bronchial walls, the presence of linear or nodular opacities, and emphysema. To correlate the smoking habits with the increase of overall lung markings in chest radiography, the ILO profusion score was converted to numbers ranging from zero to nine. Chest radiographs were rated according to the complete set of standard films of the revised ILO classification. RESULTS: 63/85 (74%) of the smokers showed an increase in overall lung markings on chest radiography; 32 (37%) had an ILO profusion score of <1/1, 29 (34%) had an ILO profusion score of <2/2 and 2 (2%) had an ILO score of ≥ 2/2. There was a significant positive linear correlation between the increase of overall lung markings on chest radiography and the cigarette consumption quantified as pack years (r=0.68). The majority of the heavy smokers (>40 pack years) showed emphysema; there was no significant difference between the prevalence of emphysema as diagnosed by CT (62%) or chest radiography (71%) (p<0.05).The most common findings in CT were thickening of bronchial walls (64%) and the presence of emphysema (62%) and of intralobular opacities (61%). Ground-glass opacities were seen in only 7% of our patients. CONCLUSION: Bronchial wall thickening and intralobular opacities as seen in CT showed a positive linear correlation with the increase of overall lung markings on chest radiography.
OBJECTIVES: Cigarette smoking-induced airway disease commonly results in an overall increase of non-specific lung markings on chest radiography. This has been described as "dirty chest". As the morphological substrate of this condition is similar to the anthracosilicosis of coal workers, we hypothesised that it is possible to quantify the radiological changes using the International Labour Organization (ILO) classification of pneumoconiosis. The aims of this study were to evaluate whether there is a correlation between the extent of cigarette smoking and increased lung markings on chest radiography and to correlate the chest radiographic scores with findings on CT studies. METHODS: In a prospective analysis a cohort of 85 smokers was examined. The cigarette consumption was evaluated in pack years (defined as 20 cigarettes per day over 1 year). Film reading was performed by two board-certified radiologists. Chest radiographs were evaluated for the presence of thickening of bronchial walls, the presence of linear or nodular opacities, and emphysema. To correlate the smoking habits with the increase of overall lung markings in chest radiography, the ILO profusion score was converted to numbers ranging from zero to nine. Chest radiographs were rated according to the complete set of standard films of the revised ILO classification. RESULTS: 63/85 (74%) of the smokers showed an increase in overall lung markings on chest radiography; 32 (37%) had an ILO profusion score of <1/1, 29 (34%) had an ILO profusion score of <2/2 and 2 (2%) had an ILO score of ≥ 2/2. There was a significant positive linear correlation between the increase of overall lung markings on chest radiography and the cigarette consumption quantified as pack years (r=0.68). The majority of the heavy smokers (>40 pack years) showed emphysema; there was no significant difference between the prevalence of emphysema as diagnosed by CT (62%) or chest radiography (71%) (p<0.05).The most common findings in CT were thickening of bronchial walls (64%) and the presence of emphysema (62%) and of intralobular opacities (61%). Ground-glass opacities were seen in only 7% of our patients. CONCLUSION: Bronchial wall thickening and intralobular opacities as seen in CT showed a positive linear correlation with the increase of overall lung markings on chest radiography.
Authors: E Spaggiari; M Zompatori; A Verduri; A Chetta; C Bnà; F Ormitti; N Sverzellati; E Rabaiotti Journal: Radiol Med Date: 2005 Jan-Feb Impact factor: 3.469
Authors: M Miniati; S Monti; J Stolk; G Mirarchi; F Falaschi; R Rabinovich; C Canapini; J Roca; K F Rabe Journal: Eur Respir J Date: 2007-12-05 Impact factor: 16.671
Authors: Samuel Y Ash; Rola Harmouche; Rachel K Putman; James C Ross; Alejandro A Diaz; Gary M Hunninghake; Jorge Onieva Onieva; Fernando J Martinez; Augustine M Choi; David A Lynch; Hiroto Hatabu; Ivan O Rosas; Raul San Jose Estepar; George R Washko Journal: Chest Date: 2017-05-12 Impact factor: 9.410
Authors: Marek A Mikulski; Alicia K Gerke; John D Newell; Ann M Murray; Carmen J Smith; Laurence J Fuortes Journal: Int J Occup Environ Health Date: 2016-05-04
Authors: Samuel Y Ash; Rola Harmouche; James C Ross; Alejandro A Diaz; Farbod N Rahaghi; Gonzalo Vegas Sanchez-Ferrero; Rachel K Putman; Gary M Hunninghake; Jorge Onieva Onieva; Fernando J Martinez; Augustine M Choi; Russell P Bowler; David A Lynch; Hiroto Hatabu; Surya P Bhatt; Mark T Dransfield; J Michael Wells; Ivan O Rosas; Raul San Jose Estepar; George R Washko Journal: Radiology Date: 2018-06-05 Impact factor: 29.146