| Background:Pneumothorax is the accumulation of air between the parietal pleura and the visceral pleura.Pneumothorax can be divided into three categories: spontaneous pneumothorax,traumatic pneumothorax,and iatrogenic pneumothorax.Spontaneity pneumothorax can be divided into primary spontaneous pneumothorax and secondary spontaneous pneumothorax according to whether there are obvious or potential causes before the onset.Primary spontaneous pneumothorax(PSP)is a relatively common disease in clinic.It is most commonly seen in slim and elongated male aged 14 to 25 years.There are many etiologies of PSP,and the pathogenesis of PSP is still not clear up to now.One possible pathophysiological mechanism is that the morphological changes of the chest lead to the biomechanical changes of the lung,leading to the occurrence of PSP.With previous research results show that the PSP in patients with thoracic flat,but it is little related research to analyze the PSP in thoracic patients and normal plane transverse diameter,diameter,height of lung and thoracic line diameter ratio before and after the thoracic imaging data such as diversity,and its correlation with the PSP,and not considering the influence of age,sex,weight,BMI index.Objective:The purpose of this retrospective study was to analyze the thoracic imaging features and clinical indicators related to PSP,and to explore the relationship between PSP and primary spontaneous pneumothorax.Methods:A total of 51 patients with primary spontaneous pneumothorax who came to our hospital for treatment from January 2018 to January 2020 were selected as the pneumothorax group.The inclusion conditions were: male,aged 14 to 37 years old,no obvious lung lesions or other special medical history by chest CT or examination;The non~pneumothorax group included 32 healthy males who came to our hospital for physical examination during the same period as the control group.The study group and the control group were divided into 2 subgroups according to 14~18 years old and 19~37 years old,respectively.Using the hospital PACS system on chest CT image positioning 10 plane,namely 3~12 thoracic plane,respectively before and after the measurement of the thoracic diameter D(the distance between the same plane after the sternum and anterior),transverse diameter T(within the same plane thoracic the maximum distance between the left and right side),simulating lung height H(bilateral lung pointed to bilateral diaphragmatic muscle of high and low distance average).Calculate the relative diameter ratio: the transverse diameter/anteroposterior diameter was denoted as A to represent the degree of flatness,the lung height/anteroposterior diameter was denoted as B,the lung height/transverse diameter was denoted as C,and B and C were denoted as the degree of thinness.Height,body weight,BMI,measured length of each plane diameter line,and ratio of each plane diameter line were compared between the two groups.Statistical analysis was performed on all kinds of data using SPSS25.0 to find out the data with significant differences between the two groups.The data with significant differences were analyzed for the occurrence of primary spontaneous pneumothorax to determine the index with the highest correlation,and Logistic regression analysis was conducted.Results:(1)There was no significant difference in age and height between the pneumothorax group and the non~pneumothorax group(P BBB 0 0.05).(2)There were significant differences in body weight and BMI(P < 0.05).The body weight and BMI of PSP group were lower than those of the control group under the same height condition,and the BMI of PSP group(18.89±2.37)was lower than the normal value(20.00~25.00),which were negatively correlated with the occurrence of PSP.(3)There were significant differences in the diameters between PSP group and control group,including the thoracic transverse diameters at the level of the 9th to 12 th thoracic vertebra,the anteroposterior thoracic diameters and the lung height at the levels of the 3rd to 5th thoracic vertebra and the 11 th thoracic vertebra(P < 0.05).The transverse diameters and anteroposterior thoracic diameters were negatively correlated with the occurrence of PSP,while the lung height was positively correlated with the occurrence of PSP.(4)There were significant differences in all diameter line ratios except A8~A12,B9 and B12 between the two groups(P<0.05),and the thoracic diameter line ratios were positively correlated with the occurrence of PSP.Stratified by age group,there were significant differences between the two groups in 14~18years old except A7~A12 and B12,while there were significant differences in 19~37years old except A7,B12 and D12.(5)Among all the indexes correlated with the occurrence of PSP,C11 had the strongest correlation with the occurrence of PSP(R2=0.396,P < 0.01).Binary Logistic regression and ROC analysis showed that C11 was an obvious risk factor for the occurrence of primary spontaneous pneumothorax,and the prediction accuracy was 88.1%(P < 0.01)when the C11 > was 0.989.Conclusion:(1)The occurrence of primary spontaneous pneumothorax was related to the morphological characteristics of thoracic imaging,BMI and body weight.(2)Flat and elongated thorax and low BMI are the risk factors for PSP,and elongated thorax is the main characteristic of PSP patients.(3)The ratio of lung height to the horizontal thoracic diameter at the level of the 11 th thoracic vertebra is a relatively stable parameter,which can be used as an important reference index for the diagnosis and treatment of PSP. |
PDF Full Text Request