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Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years)

Objective To explore the rationality of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Multi-slice Computed Tomography (MSCT) chest examination of young people (18 – 40 years). Materials and methods Of the 6710 pieces of the chest MSCT data collected from healthy subjects aged 18 to 40 years, 152 were diagnosed with sPAPHA and were divided into two groups (group A and B). Among them, 51 cases showing radiologic pleuroparenchymal fibroelastosis (radio-PPFE) were classified as group A, the remaining 101 cases group B. The image of lung apex, the inclination angle of the median rib (IAR), the anteroposterior to transverse diameter ratio (R) and the shape of cupula pleurae were compared between the two groups. 37 cases of spontaneous pneumothorax were also taken into consideration to observe the pleural cavity adhesions attached to the rough surface. Results The diagnostic rate of sPAPHA was 2.27% and radio-PPFE was 0.76%, accounting for 33.55% of sPAPHA. The pleural thickness of lung apex was 4.69±2.56 mm in group A, greater than 2.86±1.47 mm in group B; the displayed rate of apex line was 76.47% in group A, higher than 3.96% in group B; the size of IAR was (51.42±7.23) in group A, smaller than (59.25±9.37) in group B; the R value was 2.89±1.65 in group A, greater than 2.21±1.02 in group B; and the proportions of arc type and depressed pleural apices were 21.57% and 78.43% in group A, 88.12% and 11.88% in group B. The differences above were of statistical significance (P<0.05). In 37 cases of spontaneous pneumothorax, there were 74 cases of inflated pleural cavity on the rough pleural surface with striated shadow, and 7 cases of pleural cavity adhesion (9.46%). Conclusion The diagnosis of early mild PPFE may be reasonable, as sPAPHA partially presents as radio-PPFE and has flat chest features. Rough pleural surfaces with pleural cavity at the striated shadow could not be used as evidence for the diagnosis of pleural adhesion.

Pulmonary Apex, Flat thorax, Pleura, MSCT

He Xinhua, Cao Hetao. (2023). Diagnostic Value of Simple Pulmonary Apex Pleural Hypertrophy and Adhered (sPAPHA) in Chest CT Examination of Young People (18-40 Years). American Journal of Clinical and Experimental Medicine, 11(3), 52-57.

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This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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