title: Detection of blebs and bullae in patients with primary spontaneous pneumothorax by multi-detector CT reconstruction using different slice thicknesses.
abstract: BACKGROUND
  The aim of this study was to compare the diagnostic performances of multi-detector computed tomography (MDCT) reconstruction at two different slice thicknesses (1 mm, 'high resolution' vs. 5 mm, 'routine') with respect to the detection of blebs and bullae (BBs) in patients with primary spontaneous pneumothorax (PSP).
  
  
  METHODS
  Thirty-one patients underwent wedge resection of BBs (29 unilateral and 2 bilateral) for PSP from January 2010 to January 2013. Two observers assessed the presence and locations of BBs independently using high-resolution CT (HRCT) and routine CT reconstruction, and compared the sensitivities of each reconstruction method for BB detection using operative findings as a standard reference. In addition, the number of BBs in each CT image set was recorded and inter-observer agreements were evaluated.
  
  
  RESULTS
  Sensitivity for the detection of BBs was significantly better for HRCT than routine CT (97.0% vs. 63.6% for observer 1 and 94.0% vs. 57.6% for observer 2, respectively, both P-values < 0.001). On a per-bleb and a per-bulla basis, inter-observer agreements regarding BBs by HRCT were good and very good (k = 0.66 and 0.94, respectively) and superior to those determined by routine CT (k = 0.59 and 0.60, respectively).
  
  
  CONCLUSIONS
  Different slice thickness reconstructions influence the diagnostic efficacy of MDCT for the detection of BBs in patients with PSP. High-resolution thin slice CT reconstruction was found to have a significantly greater sensitivity than routine thicker slice thickness reconstruction for the detection of BBs.
authors.affiliation: School of Medicine, Gachon University, Incheon, Korea.
authors.forename: Ki Hyun
authors.initials: KH
authors.lastname: Lee
authors.forename: Kun Woo
authors.initials: KW
authors.lastname: Kim
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kim
authors.forename: Jae-Ik
authors.initials: JI
authors.lastname: Lee
authors.forename: Young Saing
authors.initials: YS
authors.lastname: Kim
authors.forename: Sung Youl
authors.initials: SY
authors.lastname: Hyun
authors.forename: Hyung Sik
authors.initials: HS
authors.lastname: Kim
authors.forename: Jeong Ho
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D001768:Blister / Q000150:complications / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008954:Models, Biological; D061330:Multidetector Computed Tomography / Q000379:methods*; D015588:Observer Variation; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000209:etiology; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: CT; bleb; bulla; pneumothorax; spontaneous pneumothorax