Evaluation of Pulmonary Lobe Variations Using Multidetector Row Computed Tomography

Purpose: To examine incomplete pulmonary lobes and their variations using multiplanar reformation (MPR) techniques of isotropic voxel data produced by multidetector row computed tomography (CT). Materials and Methods: The subjects were 1000 patients who underwent thoracic CT. All examinations were performed using 16-row multidetector CT with a slice thickness of 1 mm. Interlobar fissures were observed by scrolling MPR techniques for various directions. Results: Incomplete interlobar fissure was observed in 42.2% of subjects. Incomplete interlobar fissures between the right upper and middle lobes were observed in 20.4% of subjects, right major fissure was recorded in 17.4%, and left major fissure in 19.2%. Excessive fissure formation was observed in 8% of subjects (4 lobes on the right in 5.7%, 3 lobes on the left in 2.3%). Approximately half of the subjects with incomplete interlobar fissures had coexisting abnormalities in other lobes, whereas approximately one third of those with excessive fissures had coexisting abnormalities in other lobes. Conclusions: The incidence of incomplete lobulation observed by multidetector CT in this study is remarkably lower than that reported in previous CT studies but is comparable with that reported from autopsy results. It is important to perform multidirectional observation using MPR.

[1]  Variations in interlobar fissures. , 1947, The American journal of roentgenology and radium therapy.

[2]  Douglas W. MacEwan,et al.  Roentgenologic Anatomy of the Lung. , 1979 .

[3]  B. Raasch,et al.  Radiographic anatomy of the interlobar fissures: a study of 100 specimens. , 1982, AJR. American journal of roentgenology.

[4]  A. Proto,et al.  Computed tomography of the major and minor fissures. , 1983, AJR. American journal of roentgenology.

[5]  M. Laval-jeantet,et al.  [Incomplete and accessory pulmonary fissures studied by high resolution x-ray computed tomography]. , 1988, Journal de radiologie.

[6]  J. Frija,et al.  Scissures pulmonaires incomplètes et scissures accessoires étudiées par la tomodensitométrie en haute résolution. , 1988 .

[7]  S S Sagel,et al.  Anatomy of the major fissure: evaluation with standard and thin-section CT. , 1991, Radiology.

[8]  H Uchida,et al.  Incomplete interlobar fissures: bronchovascular analysis with CT. , 1993, Radiology.

[9]  A. Aziz,et al.  Radiographic and CT appearances of the major fissures. , 2001, Radiographics : a review publication of the Radiological Society of North America, Inc.

[10]  A. Aziz,et al.  High Resolution CT Anatomy of the Pulmonary Fissures , 2004, Journal of thoracic imaging.