We investigated the effectiveness of thin-section computed tomography (CT) for the diagnosis of bullous lesions in patients with spontaneous pneumothorax. The study group consisted of 74 patients. Apical regions of the lung were scanned for lesions by thin-section CT prior to operation. The presence, number, and locations of bullous lesions were assessed. Bullous lesions were also classified into 2 groups according to their shape as demonstrated by CT findings. Operative findings confirmed that 73 of the 74 patients had bullous lesions. Of these, 33 had a single bulla and 40 had multiple bulla. Thin-section CT accurately detected the presence and location of the bullous lesions, accurately identified the number in all but 6 patients with multiple bulla (accuracy: 91.8%), and also classified them accurately by type. Precise evaluations of bullous lesions are crucial to the treatment of patients with spontaneous pneumothorax. The presence of bullous lesions, as well as their location and shape, are important factors in determining whether to operate or not. Such information also allows for a better understanding of the surgical options available. Our study demonstrated that thin-section CT of apical regions of the lung is an effective diagnostic procedure for patients with spontaneous pneumothorax.

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