The feasibility of axial and coronal combined imaging using multi-detector row computed tomography for the diagnosis and treatment of a primary spontaneous pneumothorax

Forty-eight patients with pneumothorax had multi-detector computed tomography (MDCT) reconstruction using the coronal view. ELCs were evaluated in the axial and coronal view by a radiologist. A surgeon performed intra-operative examinations of the ELCs. The sensitivity of the different views was compared.The detection sensitivity was 74.4% (70/94) for the axial view and 91.5% (86/94) for the axial-coronal combined view. The intra-operative detection rate was 95.7% (90/94). The preoperative detection of ELCs on the axial-coronal combined view was significantly higher than on the conventional axial view alone (p < 0.01).Evaluation of ELCs on the axial and coronal combined HRCT improved the sensitivity of preoperative detection of ELCs compared to the conventional single axial HRCT. This increased sensitivity will help decrease the recurrence with VATS.The recurrence of a pneumothorax after video assisted thoracic surgery (VATS), after the treatment of primary spontaneous pneumothorax, is higher than after thoracotomy procedures [1-8]. Although it is difficult to prove the cause of higher recurrence rates, it has been suggested that videoscopic inspection is less accurate than direct inspection; this is because the lung is collapsed during VATS, and therefore the frequency of overlooking emphysematous like changes (ELCs) is higher with VATS procedures.The multi-detector computed tomography (MDCT) provides extended volume coverage of the longitudinal axis and high image quality in a short time, using an even higher pitch. With volumetric CT acquisition, thin collimation, and high pitch, and contiguous thin slice images can be generated that facilitate accurate assessment of focal and diffuse lung disease [9]. The volumetric CT acquisition also makes it possible to generate high-resolution multi-planar reformation (MPR) images. These technical advances have also improved the agreement between clinicians in the diagnosis of emphysematous lung disease, when the MPR images