HRCT与支气管造影诊断支气管扩张症的对照研究

Diagnosis of Bronchiectasis: A Comparison of HRCT with Bronchography

目的 评价CT和高分辨率CT(HRCT)在肺段水平诊断支气管扩张症 (支扩 )的价值。材料与方法 对 2 8例临床诊断为支扩的患者共 494个肺段分别行 10mm层厚CT、HRCT和支气管造影检查 ,其中 5例进行SpiralCT检查。 2位观察者用盲法对支扩的类型和范围进行评价。结果 以支气管造影为金标准 ,10mm层厚CT诊断支扩的敏感性、特异性、准确性分别为 65 .5 %、10 0 %、91.9% ;HRCT诊断支扩的敏感性、特异性、准确性分别为 91.3%、99.7%、97.8%。结论 HRCT诊断支扩的敏感性、特异性、准确性接近支气管造影 ,可取代大部分支气管造影检查 ;SpiralCT在支扩的诊断中有更好的应用前景。

Objective To evaluate conventional CT and HRCT in the diagnosis of bronchiectasis at pulmonary segmental level.Materials and Methods Both CT and bronchography were performed in 28 patients (total 494 pulmonary segments) with clinically suspected bronchiectasis. Using double blind method, the type and extent of bronchiectasis were assessed by two radiologists independently.Results Taking bronchographic results as a gold standard, the sensitivity, specificity and diagnostic accuracy for bronchiectasis with conventional CT (slice thickness 10mm) were 65.5%, 100% and 91.9%, respectively, while with HRCT were 91.3%, 99.7% and 97.8%, respectively.Conclusion In the diagnosis of bronchiectasis, HRCT carries as quite similar high sensitivity, specificity and accuracy as bronchography does, thus, it can replace bronchography in most cases.