Masters I B, Eastburn M M, Wootton R, Ware R S, Francis P W, Zimmerman P V, Chang A B
Department of Respiratory Medicine, Royal Children's Hospital, Herston 4029, Brisbane, Australia.
Thorax. 2005 Aug;60(8):652-8. doi: 10.1136/thx.2004.034421.
Accurate measurements of airway and lesion dimensions are important to the developmental progress of paediatric bronchoscopy. The malacia disorders are an important cause of respiratory morbidity in children, but no methods are currently available to measure these lesions or the airway lumen accurately. A new measurement technique is described here.
The magnification power of a paediatric videobronchoscope was defined and a simple and user friendly computer based program (Image J) was used to develop an objective technique (colour histogram mode technique, CHMT) for measurement of the airway lumen.
In vivo intra-observer and inter-observer repeatability coefficients for repeated area measurements from 28 images using the Bland-Altman method were 0.9 mm2 and 1.6 mm2, respectively. The average intraclass correlation coefficient for repeated measurements of area was 0.93. In vitro validation measurements using a 2 mm diameter tube resolved radii measurements to within 0.1 mm (coefficient of variability 8%). An "acceptable result" was defined in 92% of 734 images completed with the CHMT alone and 8% with its modification. The success rate for two of three images being within 10% of each other's area was 100%. Measurements of cricoid cross sectional areas from 116 patients compared with expected airway areas for age derived from endotracheal tube sizes were comparable.
The CHMT method of identifying and measuring airway dimensions is objective, accurate, and versatile and, as such, is important to the future development of flexible videobronchoscopy.
气道和病变尺寸的准确测量对小儿支气管镜检查的发展进程至关重要。软化症是儿童呼吸疾病的重要病因，但目前尚无准确测量这些病变或气道管腔的方法。本文描述了一种新的测量技术。
定义了小儿视频支气管镜的放大倍数，并使用一个简单且用户友好的基于计算机的程序（Image J）开发了一种用于测量气道管腔的客观技术（彩色直方图模式技术，CHMT）。
使用布兰德-奥特曼方法对28幅图像进行重复面积测量时，体内观察者内和观察者间的重复性系数分别为0.9平方毫米和1.6平方毫米。面积重复测量的平均组内相关系数为0.93。使用直径2毫米的管子进行体外验证测量时，半径测量精度可达0.1毫米以内（变异系数8%）。仅使用CHMT完成的734幅图像中，92%获得了“可接受结果”，8%通过其修改获得。三幅图像中有两幅的面积彼此相差在10%以内的成功率为100%。对116例患者的环状软骨横截面积测量结果与根据气管内导管尺寸得出的预期年龄气道面积相当。
CHMT方法用于识别和测量气道尺寸客观、准确且通用，因此对可弯曲视频支气管镜检查的未来发展具有重要意义。
