Valor de la tomografía computarizada en el diagnóstico de neumoconiosis complicada de mineros del carbón

Martínez González, C.; Fernández Rego, G.

doi:10.1016/S0300-2896(15)30671-2

Archivos de Bronconeumología

ISSN: 0300-2896

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Vol. 33. Issue 1.

Pages 12-15 (January 1997)

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Pages 12-15 (January 1997)

DOI: 10.1016/S0300-2896(15)30671-2

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Valor de la tomografía computarizada en el diagnóstico de neumoconiosis complicada de mineros del carbón

Value of computed tomography for the diagnosis of complicated pneumoconiosis in coal miners

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C. Martínez González1, G. Fernández Rego

Servicio de Medicina Preventiva, Diagnóstico y Valoración. Hospital General de Asturias

J.R. Jiménez Fernández-Blanco*

* Servicio de Radiología. Instituto Nacional de Silicosis. Hospital General de Asturias

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Con el fin de precisar el valor de la tomografía computarizada (TC) en el diagnóstico de neumoconiosis complicada o fibrosis masiva progresiva (FMP), se estudiaron de manera prospectiva 127 sujetos que habían trabajado en el interior de minas de carbón durante un período de tiempo superior a 15 años. Tenían neumoconiosis simple (NS) 62 sujetos (profusión nodular ≥ 1/1 según la clasificación internacional ILO-80) en la radiografía simple de tórax y ninguno FMP.

La TC permitió diagnosticar FMP en 8 casos (6,3%; IC 95%: 2,68-11,82). En estos casos la FMP era de categoría A y todos tenían neumoconiosis simple en la radiografía de tórax. De éstos, seis (75%) tenían nodulación q y/o r y cinco (62,5%) tendencia confluente. Estas cifras son significativamente más altas (p < 0,05; test de Fisher) que en el grupo sin FMP, en el que 54 (45,3%) tenían neumoconiosis simple, dos (1,68%) nodulación q y/o r y tres (2,52%) tendencia confluente.

No hemos encontrado diferencias en los valores CVF, VEMS, relación VEMS/CVF y DLCO entre los grupos con y sin FMP.

Estos resultados sugieren que la TC puede ser útil en el diagnóstico de FMP en algunos casos en que ésta se sospeche por hallazgos en la radiografía de tórax (neumoconiosis simple, nodulación q y/o r, tendencia conglomerante).

Palabras clave:

Neumoconiosis de los mineros del carbón

Fibrosis masiva progresiva

Tomografía computarizada

To assess the valué of computed tomography (CT) scanning for the diagnosis of complicated pneumoconiosis, or Progressive massive fibrosis (PMF), we conducted a prospective study of 127 subjects who had worked in coal mines for at least 15 years. Sixty-two suffered simple pneumoconiosis (nodular profusión ≥ 1/1 under the ILO-80 international classification System) visible on simple chest films. None were diagnosed of PMF on the basis of x-ray evidence.

CT led to a diagnosis of PMF in 8 cases (6.3%; CI 95%, 2.68-11.82). PMF was category A in all 8; all of them had had chest film evidence of simple pneumoconiosis. Six (75% of these patients had q and/or r nodulation; in 5 (62.5%) the nodules tended to confluence. These figures were significantly higher (p < 0.05, Fisher's test) than in the group of patients with no PMF, among whom 54 (45.3%) had SP, 2 (1.68%) had q and or r nodulation and 3 (2.52%) tended to confluence. We observed no differences in FVC, FEV1, the FEV1/FVC ratio or DLCO between the PMF and non PMF groups.

Our results suggest that CT scans can be useful for diag- nosing PMF in some cases in which it is suspected bases on chest X-ray findings (simple pneumoconiosis, q and/or r nodulation, tendency to confluence).

Key words:

Coal miners’ pneumoconiosis

Progressive massive fibrosis

Computed tomography

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