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Related Experiment Videos

Surgically treated pneumothorax. Radiologic and pathologic findings

K G Jordan1, J S Kwong, J Flint

  • 1Department of Radiology, University of British Columbia, Canada.

Chest
|February 1, 1997
PubMed
Summary

Most surgically treated pneumothorax patients have emphysema or bullae. While imaging may miss these, it likely doesn't alter management. Radiographs can detect other pneumothorax causes.

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Area of Science:

  • Pulmonary Medicine
  • Radiology
  • Thoracic Surgery

Background:

  • Recurrent or persistent pneumothorax often requires surgical intervention.
  • Identifying underlying pulmonary abnormalities is crucial for diagnosis and treatment planning.

Purpose of the Study:

  • To compare preoperative chest imaging (radiographs and CT scans) with histologic findings in patients undergoing surgery for pneumothorax.
  • To evaluate the diagnostic accuracy of imaging modalities in detecting pulmonary abnormalities associated with pneumothorax.

Main Methods:

  • Retrospective review of chest radiographs from 116 patients who had thoracotomy for pneumothorax.
  • Performance of CT scans in 21 patients.
  • Independent review of imaging by two observers and histologic specimens by a pathologist.

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Main Results:

  • Radiographs revealed parenchymal abnormalities in 68% and pleural thickening in 4% of patients.
  • Common radiographic findings included apical bullae (51%), apical scarring (17%), and emphysema (9%).
  • CT scans detected abnormalities in 95% of cases, identifying emphysema in four patients with normal radiographs and additional findings in six.

Conclusions:

  • Emphysema or isolated bullae are common in surgically treated pneumothorax patients.
  • While CT may reveal findings missed by radiographs, it may not alter patient management.
  • Radiographs can often identify findings consistent with other causes of pneumothorax.