title: Presence of subpleural pulmonary interstitial emphysema as an indication of single or multiple alveolar ruptures on CT in patients with spontaneous pneumomediastinum.
abstract: Background There are no previous reports regarding the computed tomography (CT) findings of subpleural pulmonary interstitial emphysema (PIE) in patients with spontaneous pneumomediastinum. Purpose To evaluate CT findings of subpleural PIE that may indicate a direct site of terminal alveolar rupture. Material and Methods We retrospectively evaluated chest CT and the medical records of 34 patients with spontaneous pneumomediastinum. Subpleural PIE was defined as the presence of an interstitial air collection in the subpleural portion of the lungs excluding the bronchovascular bundle. Results Subpleural PIE on CT was identified in six of 34 patients (17.6%) with spontaneous pneumomediastinum. In four of these (66.7%), subpleural PIE was present in multiple lobes suggesting multiple simultaneous ruptures of terminal alveoli. The shape of subpleural PIE was elongated linear (4/6), branching and linear (1/6), and elliptical (1/6). Conclusion The presence of subpleural PIE on CT suggests an origin of pneumomediastinal air from alveolar rupture.
authors: 1 Department of Diagnostic Radiology, CHA University College of Medicine, Bundang, Republic of Korea.
authors: Hye Rin
authors: HR
authors: Kim
authors: 1 Department of Diagnostic Radiology, CHA University College of Medicine, Bundang, Republic of Korea.
authors: Seung Min
authors: SM
authors: Yoo
authors: 2 Smile Radiologic Clinic, Seoul, Republic of Korea.
authors: Hwa Yeon
authors: HY
authors: Lee
authors: 1 Department of Diagnostic Radiology, CHA University College of Medicine, Bundang, Republic of Korea.
authors: Jin Hee
authors: JH
authors: Han
authors: 3 Department of Diagnostic Radiology, University of Maryland Medical Center, Baltimore, Maryland, USA.
authors: Aletta A
authors: AA
authors: Frazier
authors: 3 Department of Diagnostic Radiology, University of Maryland Medical Center, Baltimore, Maryland, USA.
authors: Charles S
authors: CS
authors: White
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000150:complications / Q000000981:diagnostic imaging*; D011650:Pulmonary Alveoli / Q000000981:diagnostic imaging*; D011656:Pulmonary Emphysema / Q000150:complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Pneumomediastium; computed tomography (CT); spontaneous pneumomediastinum