Costal pleura: appearances at high-resolution CT.
The appearance of the costal pleura at high-resolution computed tomography (CT) was evaluated with a cadaver and 25 normal subjects. This was contrasted with the high-resolution CT appearance of the costal pleura in 15 patients with mild pleural thickening, 13 of whom had been exposed to asbestos. On high-resolution CT scans in the normal subjects, a 1-2-mm-thick line of soft-tissue attenuation at the point of contact between lung and chest wall represents the visceral and parietal pleura, pleural contents, endothoracic fascia, and innermost intercostal muscle. In a paravertebral location, the innermost intercostal muscle is lacking, and a thin line seen on high-resolution CT scans reflects pleura and endothoracic fascia. Transverse thoracic and subcostal muscles and extrapleural fat pads can be seen as tissue internal to a rib and may be confused with pleural thickening. In 13 of the 15 patients with mild pleural thickening, the 1-3-mm-thick pleura was separable from the underlying normal intercostal muscle by a layer of extrapleural fat. High-resolution CT was more sensitive than CT with 1-cm collimation in depicting this degree of pleural abnormality.
Im
J G
JG
Department of Radiology, Thoracic Imaging, University of California San Francisco 94143.
Webb
W R
WR
Rosen
A
A
Gamsu
G
G
D000368:Aged; D000369:Aged, 80 and over; D001195:Asbestosis / Q000000981:diagnostic imaging; D002102:Cadaver; D005260:Female; D006801:Humans; D007366:Intercostal Muscles / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000000981:diagnostic imaging*; D010995:Pleural Diseases / Q000000981:diagnostic imaging; D012272:Ribs / Q000000981:diagnostic imaging; D013909:Thorax / Q000033:anatomy & histology; D014057:Tomography, X-Ray Computed / Q000379:methods*