Prevalence of Pulmonary Bullae and Blebs in Postmortem CT Imaging With Potential Implications for Diving Medicine
Pulmonary bullae and blebs can result in a pneumothorax. Their prevalence in the normal population is currently unknown. Postmortem CT (PMCT) images from a forensic database were used to determine the prevalence of pulmonary bullae/blebs in the normal Dutch adult population and its consequence for d...
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| Veröffentlicht in: | Chest 2020-04, Vol.157 (4), p.916-923 |
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| creator | de Bakker, Henri M. Tijsterman, Melanie de Bakker-Teunissen, Olga J.G. Soerdjbalie-Maikoe, Vidija van Hulst, Rob A. de Bakker, Bernadette S. |
| description | Pulmonary bullae and blebs can result in a pneumothorax. Their prevalence in the normal population is currently unknown. Postmortem CT (PMCT) images from a forensic database were used to determine the prevalence of pulmonary bullae/blebs in the normal Dutch adult population and its consequence for diving medicine, as bullae and blebs are often considered a contraindication for diving.
Forensic PMCT scans of 130 adults were analyzed for the presence of bullae and/or blebs in a cross-section of the Dutch population without pulmonary disorders. The lungs had to be unharmed, expanded, and without signs of illnesses. Normal early-stage postmortem changes in the lungs were accepted.
Analysis was performed per decade. Group I (aged 21-30 years) included 26 patients. Blebs were observed in four persons; one exhibited blebs and bullae. Group II (aged 31-40 years) included 28 patients; blebs were observed in nine individuals, one with bullae. Group III (aged 41-50 years) included 27 patients; blebs were noted in nine individuals, bullae in one, and bullae and blebs in four. Group IV (aged 51-60 years) included 28 patients; blebs were noted in seven individuals and two with bullae and blebs. Group V (aged 61-70 years) included 21 patients; blebs were noted in three persons, bullae and blebs in two, and isolated bullae in one. On average, most bullae/blebs were < 10 mm, and none exceeded 20 mm.
By reassessing pulmonary PMCT scans, we found a surprisingly high incidence of small bullae and/or blebs in one-third (33.8%; 95% CI, 25.7-41.9) of the general population without underlying lung disease. This finding can have potential implications for diving medicine. |
| doi_str_mv | 10.1016/j.chest.2019.11.008 |
| format | Article |
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Forensic PMCT scans of 130 adults were analyzed for the presence of bullae and/or blebs in a cross-section of the Dutch population without pulmonary disorders. The lungs had to be unharmed, expanded, and without signs of illnesses. Normal early-stage postmortem changes in the lungs were accepted.
Analysis was performed per decade. Group I (aged 21-30 years) included 26 patients. Blebs were observed in four persons; one exhibited blebs and bullae. Group II (aged 31-40 years) included 28 patients; blebs were observed in nine individuals, one with bullae. Group III (aged 41-50 years) included 27 patients; blebs were noted in nine individuals, bullae in one, and bullae and blebs in four. Group IV (aged 51-60 years) included 28 patients; blebs were noted in seven individuals and two with bullae and blebs. Group V (aged 61-70 years) included 21 patients; blebs were noted in three persons, bullae and blebs in two, and isolated bullae in one. On average, most bullae/blebs were < 10 mm, and none exceeded 20 mm.
By reassessing pulmonary PMCT scans, we found a surprisingly high incidence of small bullae and/or blebs in one-third (33.8%; 95% CI, 25.7-41.9) of the general population without underlying lung disease. This finding can have potential implications for diving medicine.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1016/j.chest.2019.11.008</identifier><identifier>PMID: 31759963</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Age Factors ; Aged ; Autopsy - methods ; Autopsy - statistics & numerical data ; Bronchogenic Cyst - diagnostic imaging ; bullous lung disease ; chest imaging ; CT scan ; Databases, Factual ; Diagnosis ; Diving ; diving medicine ; Female ; Forensic Medicine - methods ; Forensic Medicine - statistics & numerical data ; Humans ; Lung - diagnostic imaging ; Lung - pathology ; Lung Diseases - pathology ; Male ; Middle Aged ; Netherlands ; pulmonary ; Tomography, X-Ray Computed - methods</subject><ispartof>Chest, 2020-04, Vol.157 (4), p.916-923</ispartof><rights>2019 American College of Chest Physicians</rights><rights>Copyright © 2019 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-764bec46afbe7216009c8a83cc83c4b99b7b046f377b4a6da5859b05bbfb976a3</citedby><cites>FETCH-LOGICAL-c359t-764bec46afbe7216009c8a83cc83c4b99b7b046f377b4a6da5859b05bbfb976a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31759963$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Bakker, Henri M.</creatorcontrib><creatorcontrib>Tijsterman, Melanie</creatorcontrib><creatorcontrib>de Bakker-Teunissen, Olga J.G.</creatorcontrib><creatorcontrib>Soerdjbalie-Maikoe, Vidija</creatorcontrib><creatorcontrib>van Hulst, Rob A.</creatorcontrib><creatorcontrib>de Bakker, Bernadette S.</creatorcontrib><title>Prevalence of Pulmonary Bullae and Blebs in Postmortem CT Imaging With Potential Implications for Diving Medicine</title><title>Chest</title><addtitle>Chest</addtitle><description>Pulmonary bullae and blebs can result in a pneumothorax. Their prevalence in the normal population is currently unknown. Postmortem CT (PMCT) images from a forensic database were used to determine the prevalence of pulmonary bullae/blebs in the normal Dutch adult population and its consequence for diving medicine, as bullae and blebs are often considered a contraindication for diving.
Forensic PMCT scans of 130 adults were analyzed for the presence of bullae and/or blebs in a cross-section of the Dutch population without pulmonary disorders. The lungs had to be unharmed, expanded, and without signs of illnesses. Normal early-stage postmortem changes in the lungs were accepted.
Analysis was performed per decade. Group I (aged 21-30 years) included 26 patients. Blebs were observed in four persons; one exhibited blebs and bullae. Group II (aged 31-40 years) included 28 patients; blebs were observed in nine individuals, one with bullae. Group III (aged 41-50 years) included 27 patients; blebs were noted in nine individuals, bullae in one, and bullae and blebs in four. Group IV (aged 51-60 years) included 28 patients; blebs were noted in seven individuals and two with bullae and blebs. Group V (aged 61-70 years) included 21 patients; blebs were noted in three persons, bullae and blebs in two, and isolated bullae in one. On average, most bullae/blebs were < 10 mm, and none exceeded 20 mm.
By reassessing pulmonary PMCT scans, we found a surprisingly high incidence of small bullae and/or blebs in one-third (33.8%; 95% CI, 25.7-41.9) of the general population without underlying lung disease. This finding can have potential implications for diving medicine.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Autopsy - methods</subject><subject>Autopsy - statistics & numerical data</subject><subject>Bronchogenic Cyst - diagnostic imaging</subject><subject>bullous lung disease</subject><subject>chest imaging</subject><subject>CT scan</subject><subject>Databases, Factual</subject><subject>Diagnosis</subject><subject>Diving</subject><subject>diving medicine</subject><subject>Female</subject><subject>Forensic Medicine - methods</subject><subject>Forensic Medicine - statistics & numerical data</subject><subject>Humans</subject><subject>Lung - diagnostic imaging</subject><subject>Lung - pathology</subject><subject>Lung Diseases - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Netherlands</subject><subject>pulmonary</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1PJCEQholZo-PHLzDZcNxL90LTTQ8HDzrqronGOWg8EqCrlUk3jEBP4r-Xcdw9eiCE4ql6Uw9CZ5SUlFD-e1WaV4iprAgVJaUlIfM9NKOC0YI1NfuBZoTQqmBcVIfoKMYVyW8q-AE6ZLRthOBsht6WATZqAGcA-x4vp2H0ToV3fDkNgwKsXIcvB9ARW4eXPqbRhwQjXjzi21G9WPeCn216zV8JXLJqyOX1YI1K1ruIex_wld1ssXvorLEOTtB-r4YIp1_3MXq6uX5c_C3uHv7cLi7uCsMakYqW1xpMzVWvoa0oJ0SYuZozY_KptRC61aTmPWtbXSveqWbeCE0arXstWq7YMfq1m7sO_m3KouRoo4G8lQM_RVllCaJpOG0zynaoCT7GAL1cBztmC5ISuXUtV_LTtdy6lpTK7Dp3_fwKmPQI3f-ef3IzcL4DIK-5sRBkNHZrurMBTJKdt98GfACXq5H0</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>de Bakker, Henri M.</creator><creator>Tijsterman, Melanie</creator><creator>de Bakker-Teunissen, Olga J.G.</creator><creator>Soerdjbalie-Maikoe, Vidija</creator><creator>van Hulst, Rob A.</creator><creator>de Bakker, Bernadette S.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202004</creationdate><title>Prevalence of Pulmonary Bullae and Blebs in Postmortem CT Imaging With Potential Implications for Diving Medicine</title><author>de Bakker, Henri M. ; Tijsterman, Melanie ; de Bakker-Teunissen, Olga J.G. ; Soerdjbalie-Maikoe, Vidija ; van Hulst, Rob A. ; de Bakker, Bernadette S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-764bec46afbe7216009c8a83cc83c4b99b7b046f377b4a6da5859b05bbfb976a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Autopsy - methods</topic><topic>Autopsy - statistics & numerical data</topic><topic>Bronchogenic Cyst - diagnostic imaging</topic><topic>bullous lung disease</topic><topic>chest imaging</topic><topic>CT scan</topic><topic>Databases, Factual</topic><topic>Diagnosis</topic><topic>Diving</topic><topic>diving medicine</topic><topic>Female</topic><topic>Forensic Medicine - methods</topic><topic>Forensic Medicine - statistics & numerical data</topic><topic>Humans</topic><topic>Lung - diagnostic imaging</topic><topic>Lung - pathology</topic><topic>Lung Diseases - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Netherlands</topic><topic>pulmonary</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Bakker, Henri M.</creatorcontrib><creatorcontrib>Tijsterman, Melanie</creatorcontrib><creatorcontrib>de Bakker-Teunissen, Olga J.G.</creatorcontrib><creatorcontrib>Soerdjbalie-Maikoe, Vidija</creatorcontrib><creatorcontrib>van Hulst, Rob A.</creatorcontrib><creatorcontrib>de Bakker, Bernadette S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Bakker, Henri M.</au><au>Tijsterman, Melanie</au><au>de Bakker-Teunissen, Olga J.G.</au><au>Soerdjbalie-Maikoe, Vidija</au><au>van Hulst, Rob A.</au><au>de Bakker, Bernadette S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of Pulmonary Bullae and Blebs in Postmortem CT Imaging With Potential Implications for Diving Medicine</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>2020-04</date><risdate>2020</risdate><volume>157</volume><issue>4</issue><spage>916</spage><epage>923</epage><pages>916-923</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><abstract>Pulmonary bullae and blebs can result in a pneumothorax. Their prevalence in the normal population is currently unknown. Postmortem CT (PMCT) images from a forensic database were used to determine the prevalence of pulmonary bullae/blebs in the normal Dutch adult population and its consequence for diving medicine, as bullae and blebs are often considered a contraindication for diving.
Forensic PMCT scans of 130 adults were analyzed for the presence of bullae and/or blebs in a cross-section of the Dutch population without pulmonary disorders. The lungs had to be unharmed, expanded, and without signs of illnesses. Normal early-stage postmortem changes in the lungs were accepted.
Analysis was performed per decade. Group I (aged 21-30 years) included 26 patients. Blebs were observed in four persons; one exhibited blebs and bullae. Group II (aged 31-40 years) included 28 patients; blebs were observed in nine individuals, one with bullae. Group III (aged 41-50 years) included 27 patients; blebs were noted in nine individuals, bullae in one, and bullae and blebs in four. Group IV (aged 51-60 years) included 28 patients; blebs were noted in seven individuals and two with bullae and blebs. Group V (aged 61-70 years) included 21 patients; blebs were noted in three persons, bullae and blebs in two, and isolated bullae in one. On average, most bullae/blebs were < 10 mm, and none exceeded 20 mm.
By reassessing pulmonary PMCT scans, we found a surprisingly high incidence of small bullae and/or blebs in one-third (33.8%; 95% CI, 25.7-41.9) of the general population without underlying lung disease. This finding can have potential implications for diving medicine.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31759963</pmid><doi>10.1016/j.chest.2019.11.008</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Age Factors Aged Autopsy - methods Autopsy - statistics & numerical data Bronchogenic Cyst - diagnostic imaging bullous lung disease chest imaging CT scan Databases, Factual Diagnosis Diving diving medicine Female Forensic Medicine - methods Forensic Medicine - statistics & numerical data Humans Lung - diagnostic imaging Lung - pathology Lung Diseases - pathology Male Middle Aged Netherlands pulmonary Tomography, X-Ray Computed - methods |
| title | Prevalence of Pulmonary Bullae and Blebs in Postmortem CT Imaging With Potential Implications for Diving Medicine |
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