Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years)

He Xinhua; Cao Hetao

doi:doi:10.11648/j.ajcem.20231103.12

| Peer-Reviewed

Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years)

He Xinhua, Cao Hetao

Published in American Journal of Clinical and Experimental Medicine (Volume 11, Issue 3)

Received: 4 May 2023 Accepted: 25 May 2023 Published: 6 June 2023

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Objective To explore the rationality of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Multi-slice Computed Tomography (MSCT) chest examination of young people (18 – 40 years). Materials and methods Of the 6710 pieces of the chest MSCT data collected from healthy subjects aged 18 to 40 years, 152 were diagnosed with sPAPHA and were divided into two groups (group A and B). Among them, 51 cases showing radiologic pleuroparenchymal fibroelastosis (radio-PPFE) were classified as group A, the remaining 101 cases group B. The image of lung apex, the inclination angle of the median rib (IAR), the anteroposterior to transverse diameter ratio (R) and the shape of cupula pleurae were compared between the two groups. 37 cases of spontaneous pneumothorax were also taken into consideration to observe the pleural cavity adhesions attached to the rough surface. Results The diagnostic rate of sPAPHA was 2.27% and radio-PPFE was 0.76%, accounting for 33.55% of sPAPHA. The pleural thickness of lung apex was 4.69±2.56 mm in group A, greater than 2.86±1.47 mm in group B; the displayed rate of apex line was 76.47% in group A, higher than 3.96% in group B; the size of IAR was (51.42±7.23) in group A, smaller than (59.25±9.37) in group B; the R value was 2.89±1.65 in group A, greater than 2.21±1.02 in group B; and the proportions of arc type and depressed pleural apices were 21.57% and 78.43% in group A, 88.12% and 11.88% in group B. The differences above were of statistical significance (P<0.05). In 37 cases of spontaneous pneumothorax, there were 74 cases of inflated pleural cavity on the rough pleural surface with striated shadow, and 7 cases of pleural cavity adhesion (9.46%). Conclusion The diagnosis of early mild PPFE may be reasonable, as sPAPHA partially presents as radio-PPFE and has flat chest features. Rough pleural surfaces with pleural cavity at the striated shadow could not be used as evidence for the diagnosis of pleural adhesion.

Published in	American Journal of Clinical and Experimental Medicine (Volume 11, Issue 3)
DOI	10.11648/j.ajcem.20231103.12
Page(s)	52-57
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Pulmonary Apex, Flat thorax, Pleura, MSCT

References

[1]	ZHU XIAODONG, CAO HETAO, SU HAIBING. et al. Analysis of the Chest Imaging Features of Primary Spontaneous Pneumothorax with Multi-Slice CT Scan [J]. Journal of Clinical Radiology, 2017, 36 (9): 1248-1252.
[2]	ODA T, OGURA T, KITAMURA H, et al. Distinct characteristics of pleuroparenchymal fibroelastosis with usual interstitial pneumonia compared with idiopathic pulmonary fibrosis [J]. Chest, 2014, 146: 1248-1255.
[3]	ZHANG JICHUN, GU KE. Measurement of normal apex pulmonis companion shadow on the chest film [J]. Shanghai Medical Imaging, 2005, 14 (3): 213-214.
[4]	ENOMOTO Y, NAKAMURA Y, COLBY T V, et al. Radiologic pleuroparenchymal fibroelastosis like lesion in connective tissue disease-related interstitial lung disease [J]. PLoS One, 2017, 12 (6) e0180283.
[5]	LIANG C, SHUANG L, WEI L, et al. Correlative anatomy of the pleura and pleural spaces [J]. ThoracSurg Clin, 2011, 21: 177–182.
[6]	HARADA T, YOSHIDA Y, KITASATO Y, et al. The thoracic cage becomes flattened in the progression of pleuroparenchymal fibroelastosis [J]. Eur Respir Rev, 2014, 23: 263-266.
[7]	ESTEVES C, COSTAF R, REDONDO T, et al. Pleuroparenchymal fibroelastosis: role of high-resolution computed tomography (HRCT) and CT-guided transthoracic core lung biopsy [J]. Insights Imaging, 2016, 7 (1): 155–162.
[8]	ENOMOTO Y, MATSUSHIMA S, MEGURO S, et al. Podoplanin-positive myofibroblasts: a pathologic hallmark of pleuroparenchymal fibroelastosis [J]. Histopathology, 2018, 72 (7): 1209-1215.
[9]	HIRAMI Y, NAKATA M, MAEDA, et al. Pulmonary apical mass, the so-called pulmonary apical cap, in a 43-year-old woman [J]. Ann Thorac Cardiovasc Surg, 2010, 16: 122-124.
[10]	CASHA A R, MANCHÉ A, GATT R, et al. Is there a biomechanical cause for spontaneous pneumothorax [J]? European Journal of Cardio-Thoracic Surgery, 2014, 45 (6): 1011–1016.
[11]	CAO HETAO, WANG SUJUAN, ZHANG YANMAN, et al. Manifestation of CT Virtual Endoscopy Images of Pleural Cavity [J]. Journal of Clinical Radiology, 2019, 38 (10): 1842-1846.
[12]	KOBAYASHI N S, NAMBU A, KAWAMOTO M, et al. Pulmonary apical opacities on thin-section computed tomography: relationship to primary spontaneous pneumothorax in young male patients and corresponding histopathologic findings [J]. J Comput Assist Tomogr, 2018, 42 (1): 33-38.
[13]	FELLER-KOPMAN D, LIGHT R. Pleural Disease [J]. N Engl J Med, 2018; 378: 740-51.
[14]	WU YONG, ZHU DONG-SHAN, YAO YUN-MING, et al. The study of preoperative detection of pleural adhesions by chest ultrasonogrphy [J]. Chinese Journal of Thoracic and Cardiovascular Surgery. 2010, 26 (3): 190-192.
[15]	ATAG E, BAS IKIZOGLU N, GOKDEMIR Y, et al. An adolescent with idiopathic pleuroparenchymal fibroelastosis, Case report [J]. Arch Argent Pediatr, 2018, 116 (1): e147-e150.

Cite This Article

Plain Text BibTeX RIS

APA Style

He Xinhua, Cao Hetao. (2023). Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years). American Journal of Clinical and Experimental Medicine, 11(3), 52-57. https://doi.org/10.11648/j.ajcem.20231103.12

Copy | Download

ACS Style

He Xinhua; Cao Hetao. Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years). Am. J. Clin. Exp. Med. 2023, 11(3), 52-57. doi: 10.11648/j.ajcem.20231103.12

Copy | Download

AMA Style

He Xinhua, Cao Hetao. Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years). Am J Clin Exp Med. 2023;11(3):52-57. doi: 10.11648/j.ajcem.20231103.12

Copy | Download

@article{10.11648/j.ajcem.20231103.12,
  author = {He Xinhua and Cao Hetao},
  title = {Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years)},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {11},
  number = {3},
  pages = {52-57},
  doi = {10.11648/j.ajcem.20231103.12},
  url = {https://doi.org/10.11648/j.ajcem.20231103.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20231103.12},
  abstract = {Objective To explore the rationality of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Multi-slice Computed Tomography (MSCT) chest examination of young people (18 – 40 years). Materials and methods Of the 6710 pieces of the chest MSCT data collected from healthy subjects aged 18 to 40 years, 152 were diagnosed with sPAPHA and were divided into two groups (group A and B). Among them, 51 cases showing radiologic pleuroparenchymal fibroelastosis (radio-PPFE) were classified as group A, the remaining 101 cases group B. The image of lung apex, the inclination angle of the median rib (IAR), the anteroposterior to transverse diameter ratio (R) and the shape of cupula pleurae were compared between the two groups. 37 cases of spontaneous pneumothorax were also taken into consideration to observe the pleural cavity adhesions attached to the rough surface. Results The diagnostic rate of sPAPHA was 2.27% and radio-PPFE was 0.76%, accounting for 33.55% of sPAPHA. The pleural thickness of lung apex was 4.69±2.56 mm in group A, greater than 2.86±1.47 mm in group B; the displayed rate of apex line was 76.47% in group A, higher than 3.96% in group B; the size of IAR was (51.42±7.23) in group A, smaller than (59.25±9.37) in group B; the R value was 2.89±1.65 in group A, greater than 2.21±1.02 in group B; and the proportions of arc type and depressed pleural apices were 21.57% and 78.43% in group A, 88.12% and 11.88% in group B. The differences above were of statistical significance (PConclusion The diagnosis of early mild PPFE may be reasonable, as sPAPHA partially presents as radio-PPFE and has flat chest features. Rough pleural surfaces with pleural cavity at the striated shadow could not be used as evidence for the diagnosis of pleural adhesion.},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years)
AU  - He Xinhua
AU  - Cao Hetao
Y1  - 2023/06/06
PY  - 2023
N1  - https://doi.org/10.11648/j.ajcem.20231103.12
DO  - 10.11648/j.ajcem.20231103.12
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 52
EP  - 57
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20231103.12
AB  - Objective To explore the rationality of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Multi-slice Computed Tomography (MSCT) chest examination of young people (18 – 40 years). Materials and methods Of the 6710 pieces of the chest MSCT data collected from healthy subjects aged 18 to 40 years, 152 were diagnosed with sPAPHA and were divided into two groups (group A and B). Among them, 51 cases showing radiologic pleuroparenchymal fibroelastosis (radio-PPFE) were classified as group A, the remaining 101 cases group B. The image of lung apex, the inclination angle of the median rib (IAR), the anteroposterior to transverse diameter ratio (R) and the shape of cupula pleurae were compared between the two groups. 37 cases of spontaneous pneumothorax were also taken into consideration to observe the pleural cavity adhesions attached to the rough surface. Results The diagnostic rate of sPAPHA was 2.27% and radio-PPFE was 0.76%, accounting for 33.55% of sPAPHA. The pleural thickness of lung apex was 4.69±2.56 mm in group A, greater than 2.86±1.47 mm in group B; the displayed rate of apex line was 76.47% in group A, higher than 3.96% in group B; the size of IAR was (51.42±7.23) in group A, smaller than (59.25±9.37) in group B; the R value was 2.89±1.65 in group A, greater than 2.21±1.02 in group B; and the proportions of arc type and depressed pleural apices were 21.57% and 78.43% in group A, 88.12% and 11.88% in group B. The differences above were of statistical significance (PConclusion The diagnosis of early mild PPFE may be reasonable, as sPAPHA partially presents as radio-PPFE and has flat chest features. Rough pleural surfaces with pleural cavity at the striated shadow could not be used as evidence for the diagnosis of pleural adhesion.
VL  - 11
IS  - 3
ER  -

Copy | Download

Author Information

He Xinhua

Department of Medical Imaging, People’s Hospital of Rugao, Rugao, China
Cao Hetao

Department of Medical Imaging, Affiliated Hospital of Nantong University, Nantong, China

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

He Xinhua, Cao Hetao. (2023). Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years). American Journal of Clinical and Experimental Medicine, 11(3), 52-57. https://doi.org/10.11648/j.ajcem.20231103.12

Copy | Download

ACS Style

He Xinhua; Cao Hetao. Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years). Am. J. Clin. Exp. Med. 2023, 11(3), 52-57. doi: 10.11648/j.ajcem.20231103.12

Copy | Download

AMA Style

He Xinhua, Cao Hetao. Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years). Am J Clin Exp Med. 2023;11(3):52-57. doi: 10.11648/j.ajcem.20231103.12

Copy | Download

@article{10.11648/j.ajcem.20231103.12,
  author = {He Xinhua and Cao Hetao},
  title = {Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years)},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {11},
  number = {3},
  pages = {52-57},
  doi = {10.11648/j.ajcem.20231103.12},
  url = {https://doi.org/10.11648/j.ajcem.20231103.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20231103.12},
  abstract = {Objective To explore the rationality of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Multi-slice Computed Tomography (MSCT) chest examination of young people (18 – 40 years). Materials and methods Of the 6710 pieces of the chest MSCT data collected from healthy subjects aged 18 to 40 years, 152 were diagnosed with sPAPHA and were divided into two groups (group A and B). Among them, 51 cases showing radiologic pleuroparenchymal fibroelastosis (radio-PPFE) were classified as group A, the remaining 101 cases group B. The image of lung apex, the inclination angle of the median rib (IAR), the anteroposterior to transverse diameter ratio (R) and the shape of cupula pleurae were compared between the two groups. 37 cases of spontaneous pneumothorax were also taken into consideration to observe the pleural cavity adhesions attached to the rough surface. Results The diagnostic rate of sPAPHA was 2.27% and radio-PPFE was 0.76%, accounting for 33.55% of sPAPHA. The pleural thickness of lung apex was 4.69±2.56 mm in group A, greater than 2.86±1.47 mm in group B; the displayed rate of apex line was 76.47% in group A, higher than 3.96% in group B; the size of IAR was (51.42±7.23) in group A, smaller than (59.25±9.37) in group B; the R value was 2.89±1.65 in group A, greater than 2.21±1.02 in group B; and the proportions of arc type and depressed pleural apices were 21.57% and 78.43% in group A, 88.12% and 11.88% in group B. The differences above were of statistical significance (PConclusion The diagnosis of early mild PPFE may be reasonable, as sPAPHA partially presents as radio-PPFE and has flat chest features. Rough pleural surfaces with pleural cavity at the striated shadow could not be used as evidence for the diagnosis of pleural adhesion.},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years)
AU  - He Xinhua
AU  - Cao Hetao
Y1  - 2023/06/06
PY  - 2023
N1  - https://doi.org/10.11648/j.ajcem.20231103.12
DO  - 10.11648/j.ajcem.20231103.12
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 52
EP  - 57
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20231103.12
AB  - Objective To explore the rationality of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Multi-slice Computed Tomography (MSCT) chest examination of young people (18 – 40 years). Materials and methods Of the 6710 pieces of the chest MSCT data collected from healthy subjects aged 18 to 40 years, 152 were diagnosed with sPAPHA and were divided into two groups (group A and B). Among them, 51 cases showing radiologic pleuroparenchymal fibroelastosis (radio-PPFE) were classified as group A, the remaining 101 cases group B. The image of lung apex, the inclination angle of the median rib (IAR), the anteroposterior to transverse diameter ratio (R) and the shape of cupula pleurae were compared between the two groups. 37 cases of spontaneous pneumothorax were also taken into consideration to observe the pleural cavity adhesions attached to the rough surface. Results The diagnostic rate of sPAPHA was 2.27% and radio-PPFE was 0.76%, accounting for 33.55% of sPAPHA. The pleural thickness of lung apex was 4.69±2.56 mm in group A, greater than 2.86±1.47 mm in group B; the displayed rate of apex line was 76.47% in group A, higher than 3.96% in group B; the size of IAR was (51.42±7.23) in group A, smaller than (59.25±9.37) in group B; the R value was 2.89±1.65 in group A, greater than 2.21±1.02 in group B; and the proportions of arc type and depressed pleural apices were 21.57% and 78.43% in group A, 88.12% and 11.88% in group B. The differences above were of statistical significance (PConclusion The diagnosis of early mild PPFE may be reasonable, as sPAPHA partially presents as radio-PPFE and has flat chest features. Rough pleural surfaces with pleural cavity at the striated shadow could not be used as evidence for the diagnosis of pleural adhesion.
VL  - 11
IS  - 3
ER  -

Copy | Download