Zusammenhang zwischen Empyhsemtyp und Schweregrad der Pneumokoniose bei Bergleuten: Korrelation von HR-CT-Befunden und ILO-Klassifikation / Correlation of different types of emphysema in high-resolution computed tomography (HR-CT) with the ILO-classification of coal workers pneumoconiosis

Purpose: The complaints of patients suffering from pneumoconiosis and the decrease in cardio-respiratory function tests are related to the major complications, emphysema or bronchitis, resp. to a lesser degree the complaints are directly influenced by the silicotic process itself. Up to now, no large study has analysed the correlation of different types and severity of emphysema with the ILO-classification of pneumoconiosis in miners. Material and Methods: In 104 miners the severity of pneumoconiosis was classified by ILO. By HR-CT the type and severity of emphysema was analysed using a 4-point-scale. The correlation of emphysema with the ILO-classification was tested with Pearson-correlation. Results: The centrolobular emphysema was the dominant type with 59%, but there was no dependence on the severity of pneumoconiosis. Only the paracicatricial emphysema had a significant correlation (p < 0.05) with the degree of large opacities. On the other hand, the paracicatricial emphysema was only detected in 32 %; under quantitative aspects it was seen to be less common than the centrolobular, the parapleural and the paraseptal emphysema (46%). There was no significant correlation with the size and distribution of the small opacities and the different types of emphysema. Conclusions: Only the large opacities had a significant correlation with the appearance of paracicatricial emphysema. The other types of emphysema, especially, the dominant centrolobular type had no obvious association with pneumoconiosis. The multifactoral genesis of emphysema has to be taken into account.