The accuracy of computed tomography in detecting surgically resectable blebs or bullae in primary spontaneous pneumothorax

• Published in: Radiologia medica Vol. 124; no. 9; pp. 833 - 837
• Main Authors: Almajid, Feras M., Aljehani, Yasser M., Alabkary, Sukainah, Alsaif, Hind S.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01-09-2019; Springer Nature B.V
• Subjects: Chest; Chest Radiology; Computation; Computed tomography; Diagnostic Radiology; Imaging; Interventional Radiology; Mathematical analysis; Medicine; Medicine & Public Health; Neuroradiology; Pneumothorax; Radiology; Sensitivity; Tomography; Ultrasound; Blebs; Bullae; Computed tomography; Primary spontaneous pneumothorax
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-019-01044-6

Objectives
Chest computed tomography is commonly used in patients with primary spontaneous pneumothorax to detect the presence of pulmonary blebs or bullae. The aim of this study is to calculate the accuracy of chest computed tomography to detect surgically resectable blebs or bullae in patients with primary spontaneous pneumothorax.
Methods
This is a retrospective study includes all patients with primary spontaneous pneumothorax who underwent chest computed tomography evaluation for their disease over the period from January 2005 to December 2015. Patients who underwent surgical exploration were sub-grouped to calculate the sensitivity and the specificity of the chest computed tomography to detect surgically resectable pulmonary blebs or bullae.
Results
A total of 143 patients were included in the study. Among them, 120 patients underwent surgical exploration with the finding of 95.7% sensitivity and 42.3% specificity for the chest computed tomography in detection of surgically resectable pulmonary blebs or bullae.
Conclusion
The sensitivity of the chest computed tomography scan is high in detecting surgically resectable pulmonary blebs or bullae. However, the specificity is low. This may lead to overdiagnosis of the patients to have pulmonary blebs and bullae. Therefore, the routine use of chest computed tomography scan before the surgical exploration in patients with primary spontaneous pneumothorax should depend on the clinical judgment.