Volumetric thin-section CT: evaluation of pulmonary interlobar fissures

Abstract

PURPOSE We aimed to perform an imaging analysis of interlobar fissures and their variations using thin-sec-tion computed tomography (CT). METHODSVolumetric thin-section CT scanning was performed in 208 subjects. Interlobar fissures were ob-served on axial images, and reconstructed coronal and sagittal images were observed by multi-planar reformatting (MPR). The vessel distributions were verified by maximal intensity projection (MIP). On the axial images, the interlobar fissures were characterized by lines of hyperattenuation, bands of hyperattenuation, avascular zones, and mixed imaging. The interlobar fissures were divid-ed into seven grades according to the percentage of defects over the entire fissure. RESULTSOn the axial images, of all interlobar fissures without avascular zones, 70.2% of the right oblique fissures (ROFs) and 94.2% of the left oblique fissures (LOFs) appeared as lines, and 83.2% of the horizontal fissures (HFs) appeared as bands. All of the interlobar fissures appeared as lines on the coronal and sagittal images. Of all cases, 17.8% showed fully complete interlobar fissures for all three fissures. Incomplete fissures included 41.3% of ROFs, 58.2% of HFs, and 45.2% of LOFs. In ROFs and LOFs, discontinuity was most frequently below 20%, while in HFs discontinuity was most frequently 41%-60%. The most common classification of incomplete interlobar fissures was a dis-continuous avascular zone. CONCLUSIONIncomplete interlobar fissures are common variations of interlobar fissures. Techniques including vol-umetric thin-section CT, MPR, and MIP can assist in the diagnosis of incomplete interlobar fissures.