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. 2010 Nov;28(9):672-9.
doi: 10.1007/s11604-010-0494-1. Epub 2010 Nov 27.

Pneumothorax and idiopathic pulmonary fibrosis

Tae Iwasawa  1 , Takashi Ogura, Hiroshi Takahashi, Akira Asakura, Toshiyuki Gotoh, Takuya Yazawa, Tomio Inoue
Affiliations

Pneumothorax and idiopathic pulmonary fibrosis

Tae Iwasawa et al. Jpn J Radiol. 2010 Nov.

Abstract

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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