PURPOSE: We evaluated the relation between the severity of idiopathic pulmonary fibrosis (IPF) and the incidence of pneumothorax on computed tomography (CT) images. MATERIALS AND METHODS: In this retrospective study, we evaluated the presence of pneumothorax in 56 consecutive patients who died of IPF from the initial CT to death. We quantitatively analyzed a total of 207 CT images and measured the volume of the normal pattern (N-pattern) and each lesion pattern on the initial CT and their serial changes. The effects of pneumothorax and clinical and CT features on survival were evaluated using Cox regression analysis. RESULTS: Pneumothorax occurred in 17 of 56 patients. Comparison of the pneumothorax (+) and (-) groups showed the initial vital capacity (VC) was lower (P = 0.005) and the follow-up period was shorter (P = 0.03) in the former group. The decrease in the N-pattern volume in the pneumothorax(+) group was significantly faster than in the pneumothorax(-) group (P = 0.013). Cox regression analyses identified a rapid decrease in N-pattern volume (P = 0.008) and a rapid decrease in VC (P = 0.002), but not pneumothorax, as significant predictors of poor survival. CONCLUSION: Pneumothorax in IPF patients is associated with lower VC and rapid deterioration of CT findings. The findings suggest that pneumothorax is a complication of advanced IPF.
PURPOSE: We evaluated the relation between the severity of idiopathic pulmonary fibrosis (IPF) and the incidence of pneumothorax on computed tomography (CT) images. MATERIALS AND METHODS: In this retrospective study, we evaluated the presence of pneumothorax in 56 consecutive patients who died of IPF from the initial CT to death. We quantitatively analyzed a total of 207 CT images and measured the volume of the normal pattern (N-pattern) and each lesion pattern on the initial CT and their serial changes. The effects of pneumothorax and clinical and CT features on survival were evaluated using Cox regression analysis. RESULTS: Pneumothorax occurred in 17 of 56 patients. Comparison of the pneumothorax (+) and (-) groups showed the initial vital capacity (VC) was lower (P = 0.005) and the follow-up period was shorter (P = 0.03) in the former group. The decrease in the N-pattern volume in the pneumothorax(+) group was significantly faster than in the pneumothorax(-) group (P = 0.013). Cox regression analyses identified a rapid decrease in N-pattern volume (P = 0.008) and a rapid decrease in VC (P = 0.002), but not pneumothorax, as significant predictors of poor survival. CONCLUSION: Pneumothorax in IPF patients is associated with lower VC and rapid deterioration of CT findings. The findings suggest that pneumothorax is a complication of advanced IPF.
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Authors: W W Douglas; J H Ryu; S J Swensen; K P Offord; D R Schroeder; G M Caron; R A DeRemee Journal: Am J Respir Crit Care Med Date: 1998-07 Impact factor: 21.405
Authors: Andrew B Servais; Cristian D Valenzuela; Alexandra B Ysasi; Willi L Wagner; Arne Kienzle; Stephen H Loring; Akira Tsuda; Maximilian Ackermann; Steven J Mentzer Journal: Physiol Rep Date: 2018-05