Résumé
Objective To observe the manifestations of MSCT and CT virtual endoscopy (CTVE) images of pleural windows in spontaneous pneumothorax.Methods MSCT data of 73 patients of spontaneous pneumothorax were analyzed.Taking pneumatized sac as the center,thin cross sectional planer (1 mm thickness) MPR and CTVE were reconstructed.Then the size and location of pleural windows,form of pleural surface defect or niche and the relationship with the chest were observed.Results In all 73 patients of spontaneous pneumothorax,27 pleural windows were detected in 15 patients with MSCT thin cross-sectional planer reconstruction image.Pleural windows were observed on the left side in 11 patients,while on the right side in 4 patients.Most of pleural windows located at apex (15/27,55.56％),followed by anterior chest wall (7/27,25.93％) and mediastinum (5/27,18.52％).The connection of pleura window with thorax was shown in 23 (23/27,85.19％).Small defection on parietal pleural with pneumatized sac bulging was seen in all pleural windows,with circular,elliptic,short columnar or hockey shapes.On the front view of CTVE,pleural windows showed niche on parietal pleural surface with round or oval form,and the bottom of the pneumatized sac could be straightly seen in 19 pleural windows.The walls were flat,tunnel shaped in 6 pleural windows,while cavernous shaped in other pleural windows.Conclusion Pleural windows often displayed as small diverticulum like shadows on parietal pleural surfaces,and the pathogenesis might be associated with negative pressure increased in local pleural cavity and pleural damages.