Unlu Elif Nisa, Balbay Ege Gulec, Boran Mertay, Sungur Mehmet Ali, Buyukkaya Ayla, Safak Alp Alper
From the Faculty of Medicine, Departments of *Radiology, †Chest Diseases, ‡Thoracic Surgery, and §Biostatistics and Medical Informatics, Duzce University; and ∥Department of Radiology, Ataturk State Hospital, Duzce, Turkey.
J Comput Assist Tomogr. 2016 Mar-Apr;40(2):256-60. doi: 10.1097/RCT.0000000000000362.
The purpose of this study was to determine the characteristics of paratracheal air cysts (PACs) and their relationship with upper lobe pulmonary fibrosis.
The routine thoracic computed tomography scans of 3549 patients carried out between January 2014 and April 2015 were retrospectively evaluated. The presence, location, structural characteristics (uniloculated or multiloculated), number of cysts, and anterior-posterior and transverse dimensions of the PAC and its communication with the tracheal lumen were evaluated. The presence of upper lobe fibrosis, emphysema, and bronchiectasis was also evaluated. The relationship between upper lobe fibrosis, emphysema, bronchiectasis, and the presence of paratracheal cysts was evaluated in all patients. An equal number of randomized patients with no paratracheal cysts were selected as a control group.
A total of 190 PAC cases were diagnosed, with a prevalence rate of 5.35%: 146 (76.8%) of the cases were men, 44 (23.2%) were female, and the mean (SD) age was 53.79 (16.64) years (range, 12-89 years). The control group included 105 men (57.4%) and 78 women (42.6%), and the mean (SD) age was 53.87 (16.65) years (range, 13-87 years). The groups were similar in terms of age (P = 0.876), whereas the proportion of men in the PAC group was significantly higher (P < 0.001). Most of the PACs were located on the right side (n = 188, 98.9%). The incidence of fibrosis in the paratracheal cyst group was 45.8% (n = 87) compared with 19.5% (n = 37) in the control group; this difference was statistically significant (P < 0.001). The prevalence rates of emphysema in the cyst group and the control group were 29.5% (n = 56) and 11.6% (n = 22), respectively, and the difference was statistically significant (P < 0.001). When the groups were compared regarding bronchiectasis (scar and non-scar related), the rate of bronchiectasis in the paratracheal cyst group was 17.9% (n = 34), compared with 3.7% (n = 7) in the control group; this difference was statistically significant (P < 0.001).
Paratracheal air cysts are relatively common, but the etiology is still unclear. We detected increased rates of cyst formation that may result from the traction effect on the tracheal wall in the presence of upper lobe fibrosis.
本研究旨在确定气管旁气囊肿（PACs）的特征及其与上叶肺纤维化的关系。
回顾性评估2014年1月至2015年4月间3549例患者的常规胸部计算机断层扫描。评估PACs的存在、位置、结构特征（单房或多房）、囊肿数量、前后径和横径及其与气管腔的连通情况。还评估上叶纤维化、肺气肿和支气管扩张的存在情况。在所有患者中评估上叶纤维化、肺气肿、支气管扩张与气管旁囊肿存在之间的关系。选择数量相等的无气管旁囊肿的随机患者作为对照组。
共诊断出190例PACs病例，患病率为5.35%：其中146例（76.8%）为男性，44例（23.2%）为女性，平均（标准差）年龄为53.79（16.64）岁（范围12 - 89岁）。对照组包括105例男性（57.4%）和78例女性（42.6%），平均（标准差）年龄为53.87（16.65）岁（范围13 - 87岁）。两组在年龄方面相似（P = 0.876），而PAC组男性比例显著更高（P < 0.001）。大多数PACs位于右侧（n = 188，98.9%）。气管旁囊肿组的纤维化发生率为45.8%（n = 87），而对照组为19.5%（n = 37）；差异具有统计学意义（P < 0.001）。囊肿组和对照组的肺气肿患病率分别为29.5%（n = 56）和11.6%（n = 22），差异具有统计学意义（P < 0.001）。当比较两组的支气管扩张（瘢痕性和非瘢痕性相关）时，气管旁囊肿组的支气管扩张率为17.9%（n = 34），而对照组为3.7%（n = 7）；差异具有统计学意义（P < 0.001）。
气管旁气囊肿相对常见，但其病因仍不清楚。我们检测到在存在上叶纤维化时，囊肿形成率增加可能是由于对气管壁的牵拉作用所致。
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