Skip to main content
Erschienen in: Pediatric Radiology 9/2007

01.09.2007 | Original Article

CT findings for blebs and bullae in children with spontaneous pneumothorax and comparison with findings in normal age-matched controls

verfasst von: Carolina V. A. Guimaraes, Lane F. Donnelly, Brad W. Warner

Erschienen in: Pediatric Radiology | Ausgabe 9/2007

Einloggen, um Zugang zu erhalten

Abstract

Background

Spontaneous pneumothorax (SPTX) is a relatively common condition. In patients with SPTX, CT has been advocated to identify blebs and bullae (BB) to help in management planning.

Purpose

The study was designed to assess our experience with CT evaluation for underlying BB in children with SPTX as compared to normal controls.

Materials and methods

Forty-three children (mean age 16 years, range 13–19 years) with 50 SPTX events with both chest radiographs and CT scans were reviewed. CT findings were compared with those seen in 29 age- and gender-matched controls without SPTX. The parameters evaluated included size, number, location, and ipsi-/contralateral BB; apical lines; and surgical correlation.

Results

In the study group, BB were identified in 14 imaged events (28%) (size 2.5–45 mm, one to six BB) with contralateral BB in 11 of the 14 (78.6%). All BB were confined to the apices. BB were sometimes difficult to differentiate from “apical lines”—a suspected normal variant seen in 28 imaged events (56%). Of blebs seen at surgery, 59% were identified on CT, and there were no false-positive CT findings. In the control group, no BB were identified but “apical lines” were seen in eight children (28%).

Conclusion

BB were seen by CT in 28% of imaged events in children with SPTX and were always confined to the apices. When present, BB were commonly bilateral (78.6%). BB should not be confused with “apical lines,” which were not only seen in 56% of imaged events in the SPTX group but also in 28% of the normal controls.
Literatur
1.
Zurück zum Zitat Warner BW, Bailey WW, Shipley RT (1991) Value of computed tomography of the lung in the management of primary spontaneous pneumothorax. Am J Surg 162:39–42PubMedCrossRef Warner BW, Bailey WW, Shipley RT (1991) Value of computed tomography of the lung in the management of primary spontaneous pneumothorax. Am J Surg 162:39–42PubMedCrossRef
2.
Zurück zum Zitat Choudhary AK, Sellars MEK, Wallis C et al (2005) Primary spontaneous pneumothorax in children: the role of CT in guiding management. Clin Radiol 60:508–511PubMedCrossRef Choudhary AK, Sellars MEK, Wallis C et al (2005) Primary spontaneous pneumothorax in children: the role of CT in guiding management. Clin Radiol 60:508–511PubMedCrossRef
3.
Zurück zum Zitat Mitlehner W, Friedrich M, Dissmann W (1992) Value of computer tomography in the detection of bullae and blebs in patients with primary spontaneous pneumothorax. Respiration 59:221–227PubMedCrossRef Mitlehner W, Friedrich M, Dissmann W (1992) Value of computer tomography in the detection of bullae and blebs in patients with primary spontaneous pneumothorax. Respiration 59:221–227PubMedCrossRef
4.
Zurück zum Zitat van Belle AF, Lamers RJ, ten Velde GP et al (2001) Diagnostic yield of computed tomography and densitometric measurements of the lung in thoracoscopically defined idiopathic spontaneous pneumothorax. Respir Med 95:292–296PubMedCrossRef van Belle AF, Lamers RJ, ten Velde GP et al (2001) Diagnostic yield of computed tomography and densitometric measurements of the lung in thoracoscopically defined idiopathic spontaneous pneumothorax. Respir Med 95:292–296PubMedCrossRef
5.
Zurück zum Zitat Smit HJ, Wienk MA, Schreurs AJ et al (2000) Do bullae indicate a predisposition to recurrent pneumothorax? Br J Radiol 73:356–359PubMed Smit HJ, Wienk MA, Schreurs AJ et al (2000) Do bullae indicate a predisposition to recurrent pneumothorax? Br J Radiol 73:356–359PubMed
6.
Zurück zum Zitat Desai SR, Wilson AG (2000) The pleura and pleural disorders. In: Armstrong P, Wilson AG, Dee P et al (eds) Imaging of diseases of the chest. Mosby, London, pp 764–765 Desai SR, Wilson AG (2000) The pleura and pleural disorders. In: Armstrong P, Wilson AG, Dee P et al (eds) Imaging of diseases of the chest. Mosby, London, pp 764–765
7.
Zurück zum Zitat Tamura M, Ohta Y, Sato H (2003) Thorascopic appearance of bilateral spontaneous pneumothorax. Chest 124:2368–2371PubMedCrossRef Tamura M, Ohta Y, Sato H (2003) Thorascopic appearance of bilateral spontaneous pneumothorax. Chest 124:2368–2371PubMedCrossRef
8.
Zurück zum Zitat Donahue DM, Cameron DW, Viale G et al (1993) Resection of pulmonary blebs and pleurodesis for spontaneous pneumothorax. Chest 104:1767–1769PubMed Donahue DM, Cameron DW, Viale G et al (1993) Resection of pulmonary blebs and pleurodesis for spontaneous pneumothorax. Chest 104:1767–1769PubMed
9.
Zurück zum Zitat Fraser RS, Muller NL, Coleman N et al (1999) Fraser and Paré’s diagnosis of diseases of the chest. Saunders, Philadelphia, pp 504–505 Fraser RS, Muller NL, Coleman N et al (1999) Fraser and Paré’s diagnosis of diseases of the chest. Saunders, Philadelphia, pp 504–505
10.
Zurück zum Zitat West JB (1971) Distribution of mechanical stress in the lung, a possible factor in localization of pulmonary disease. Lancet 24:839–841CrossRef West JB (1971) Distribution of mechanical stress in the lung, a possible factor in localization of pulmonary disease. Lancet 24:839–841CrossRef
11.
Zurück zum Zitat Donnelly LF, Emery KH, Brody AS et al (2001) Minimizing radiation dose for pediatric body applications of single-detector helical CT: strategies at a large children’s hospital. AJR 176:303–306PubMed Donnelly LF, Emery KH, Brody AS et al (2001) Minimizing radiation dose for pediatric body applications of single-detector helical CT: strategies at a large children’s hospital. AJR 176:303–306PubMed
12.
Zurück zum Zitat Brenner DJ (2002) Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative. Pediatr Radiol 4:228–233CrossRef Brenner DJ (2002) Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative. Pediatr Radiol 4:228–233CrossRef
13.
Zurück zum Zitat Sihoe AD, Yim AP, Lee TW et al (2000) Can CT scanning be used to select patients with unilateral primary spontaneous pneumothorax for bilateral surgery? Chest 118:380–383PubMedCrossRef Sihoe AD, Yim AP, Lee TW et al (2000) Can CT scanning be used to select patients with unilateral primary spontaneous pneumothorax for bilateral surgery? Chest 118:380–383PubMedCrossRef
14.
Zurück zum Zitat Lesur O, Delorme N, Fromaget JM et al (1990) Computed tomography in the etiologic assessment of idiopathic spontaneous pneumothorax. Chest 98:341–347PubMed Lesur O, Delorme N, Fromaget JM et al (1990) Computed tomography in the etiologic assessment of idiopathic spontaneous pneumothorax. Chest 98:341–347PubMed
Metadaten
Titel
CT findings for blebs and bullae in children with spontaneous pneumothorax and comparison with findings in normal age-matched controls
verfasst von
Carolina V. A. Guimaraes
Lane F. Donnelly
Brad W. Warner
Publikationsdatum
01.09.2007
Verlag
Springer-Verlag
Erschienen in
Pediatric Radiology / Ausgabe 9/2007
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-007-0537-7

Weitere Artikel der Ausgabe 9/2007

Pediatric Radiology 9/2007 Zur Ausgabe

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.