心尖胸膜实质疤痕（APPS）常见于胸部计算机断层扫描（CT），但据我们所知，从未对其影像学和临床特征进行过研究。目的是了解APPS的典型形态学表现和相关临床特征。随机发生器从2016年1月1日至2016年12月31日在城市门诊中心进行的所有21516例胸部CT中选择了1000名成年患者。患有模糊性根尖疾病的患者被排除在外。消除混杂因素。排除后，780 名患者（中位年龄：64 岁；四分位数范围：56 至 72 岁；55% 为男性）被纳入分析。两名放射科医生评估了每个 CT 的肺尖轴向平面（轻度：<5 mm，中度：5 至 10 mm，重度：>10 mm）、颅尾平面（延伸到主动脉弓的一半，更多）的异常程度。比一半，与足弓以下），主要模式（结节与网状和对称），以及进展。科恩卡帕系数用于评估放射科医生评分的一致性。使用序数逻辑回归来确定临床和影像变量与 APPS 的关联。APPS 出现在 65% (507/780) 的胸部 CT 上（54% 轻度轴向；80% 轻度颅尾）。主要模式是结节状和对称性。较大的年龄、女性、较低的体重指数、较高的身高和白人种族与更广泛的 APPS 相关。在该队列中未发现 APPS 与肺癌相关。除了主要模式之外，还可以根据轴向或头尾平面的疾病程度对 APPS 进行分类，从而能够确定统计上显着的关联，这可能有助于理解病理生理学根尖疤痕和潜在相关风险。版权所有 © 2024 Wolters Kluwer Health, Inc. 保留所有权利。

Apical pleuroparenchymal scarring (APPS) is commonly seen on chest computed tomography (CT), though the imaging and clinical features, to the best of our knowledge, have never been studied. The purpose was to understand APPS's typical morphologic appearance and associated clinical features.A random generator selected 1000 adult patients from all 21516 chest CTs performed at urban outpatient centers from January 1, 2016 to December 31, 2016. Patients with obscuring apical diseases were excluded to eliminate confounding factors. After exclusions, 780 patients (median age: 64 y; interquartile range: 56 to 72 y; 55% males) were included for analysis. Two radiologists evaluated the lung apices of each CT for the extent of abnormality in the axial plane (mild: <5 mm, moderate: 5 to 10 mm, severe: >10 mm), craniocaudal plane (extension halfway to the aortic arch, more than halfway, vs below the arch), the predominant pattern (nodular vs reticular and symmetry), and progression. Cohen kappa coefficient was used to assess radiologists' agreement in scoring. Ordinal logistic regression was used to determine associations of clinical and imaging variables with APPS.APPS was present on 65% (507/780) of chest CTs (54% mild axial; 80% mild craniocaudal). The predominant pattern was nodular and symmetric. Greater age, female sex, lower body mass index, greater height, and white race were associated with more extensive APPS. APPS was not found to be associated with lung cancer in this cohort.Classifying APPS by the extent of disease in the axial or craniocaudal planes, in addition to the predominant pattern, enabled statistically significant associations to be determined, which may aid in understanding the pathophysiology of apical scarring and potential associated risks.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.