Asbestos-related pericardial thickening detected by magnetic resonance imaging

Our plain-English summary of Asbestos-related pericardial thickening detected by magnetic resonance imaging, by N.A. Jarad, S.R. Underwood, R.M. Rudd (Respiratory Medicine, 1993).

The study

• Authors: N.A. Jarad, S.R. Underwood, R.M. Rudd
• Journal: Respiratory Medicine
• Published: 1993;87(4):309-12
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Magnetic resonance imaging was performed in four male asbestos workers in whom the chest radiograph revealed pleural but not pulmonary or pericardial disease. Patients underwent thoracic multislice spin echo imaging, with measurement of left and right ventricular volumes at end-diastole and end-systole, and a study of the flow in the superior vena cava as an indirect measure to the filling of the right ventricle. Patients also underwent respiratory function tests and high-resolution computed tomography (HRCT). Magnetic resonance, but not HRCT, showed pericardial thickening in two patients. Magnetic resonance demonstrated reduced diastolic flow in the superior vena cava in one patient, reflecting impaired right ventricular filling. All other magnetic resonance measurements of cardiac function were normal. HRCT demonstrated mild asbestosis in three patients in which neither the chest radiograph nor magnetic resonance showed signs of parenchymal disease, and pericardiac calcification without thickening in one patient. It is concluded that magnetic resonance is superior to HRCT in identifying pericardial thickening, but that HRCT is superior to magnetic resonance in identifying asbestos-related pleural and pulmonary disease.

In plain English

This report described four male asbestos workers, all of whom had worked as laggers. Their chest X-rays showed disease of the pleura (the lining around the lungs) but not of the lungs or the pericardium (the sac around the heart). All four were breathless to a degree thought to be out of proportion to their measured lung function. Each had lung function tests, high-resolution CT (HRCT) and magnetic resonance imaging (MRI) of the chest. MRI showed pericardial thickening in two patients. HRCT showed no pericardial thickening in any patient, but it did show a thin line of pericardial calcification in one patient, which MRI did not show. In one patient, MRI blood-flow measurements suggested restricted filling of the heart, which the authors assumed contributed to that patient's breathlessness. HRCT showed mild asbestosis in three patients, while MRI showed lung disease in one. HRCT also showed pleural disease better than MRI. The authors concluded that MRI was better for assessing pericardial thickening and HRCT for lung disease.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case series of four patients examined with chest radiography, lung function tests, high-resolution CT and magnetic resonance imaging
• Who was studied: Four male asbestos workers aged 38 to 60. Their chest radiographs showed pleural but no pulmonary disease. All had breathlessness of more than two on the MRC scale, thought disproportionately severe for their lung function impairment. Study place and dates are not stated.
• Exposure: Work as laggers. Per Table 1, duration of asbestos exposure was 35, 6, 2 and 5 years (patients 1 to 4) and time since first exposure was 46, 36, 22 and 27 years. Fiber type is not stated.
• Main results:
  • MRI showed pericardial thickening in two of the four patients (patients 3 and 4 in Table 2).
  • HRCT showed pericardial thickening in no patient, but showed a thin line of calcification on the front of the pericardium in one patient.
  • MRI did not show pericardial calcification in any patient.
  • In one patient, MRI flow studies of the superior vena cava showed a reduced diastolic peak, consistent with restricted ventricular filling.
  • The authors assumed that the impaired filling contributed to that patient's breathlessness.
  • All other MRI measurements of cardiac function were normal.
  • MRI showed pleural disease in all four patients and pulmonary disease in one.
  • HRCT showed mild asbestosis in three patients.
  • Pleural disease was better shown by HRCT than by MRI.
• The authors' conclusion: The authors concluded that their study confirmed that MRI is better for assessing pericardial thickening and HRCT is better for assessing lung parenchymal disease. They suggested that pericardial constriction be considered when breathlessness seems disproportionate to lung function impairment in patients with pleural disease.

Topics

Medical terms in this study, explained in our Lexicon: Pericardial, Chest X-Ray, High-Resolution CT (HRCT).

Related studies

• Asbestos-related pleural disease: value of dedicated magnetic resonance imaging techniques — M.A. Weber, M. Bock, et al. (2004)
• Magnetic resonance imaging of the thorax in the evaluation of asbestosis — S.I. Bekkelund, U. Aasebø, et al. (1998)
• The use of magnetic resonance imaging in malignant mesothelioma — J. Entwisle (2004)
• New applications of magnetic resonance imaging for thoracic oncology — Y. Ohno (2014)
• Early Contrast Enhancement: A novel magnetic resonance imaging biomarker of pleural malignancy — S. Tsim, C.A. Humphreys, et al. (2018)
• Applications of Magnetic Resonance Imaging of the Thorax in Pleural Diseases: A State-of-the-Art Review — F.M. Pessôa, A.S. de Melo, et al. (2016)

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