Nishino Mizuki, Kubo Takeshi, Kataoka Milliam L, Gautam Shiva, Raptopoulos Vassilios, Hatabu Hiroto
Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Eur J Radiol. 2006 Jul;59(1):33-41. doi: 10.1016/j.ejrad.2005.12.035. Epub 2006 Feb 15.
To evaluate the capability of coronal reformations of chest on 64-row MDCT in demonstrating thoracic abnormalities in comparison with axial images.
Thirty-eight consecutive patients who underwent pulmonary CTA on 64-row MDCT were retrospectively studied with institutional review board (IRB) approval. Contiguous 2 mm axial and coronal images were reviewed independently with a 1-week interval, by consensus reading of two board-certified radiologists. Overall image quality was graded using a five-point scale. Abnormalities in mediastinum, hilum, pulmonary vessels, aorta, heart, esophagus, pleura, chest wall, and lung parenchyma were scored: 1 = definitely absent, 2 = probably absent, 3 = equivocal, 4 = probably present, 5 = definitely present. Scores on axial and coronal images were compared using weighted kappa analysis.
Overall image quality was not different with statistical relevance between axial and coronal images (mean/median scores; 3.7/4; 3.6/4, respectively, P = 0.286, Wilcoxon signed-rank test). Significant agreement was observed between axial and coronal scores (mean weighted kappa, 0.661; range, 0.362-1). Agreement was almost perfect for pneumothorax, lung and pleural mass, effusion and consolidation (weighted kappa=0.833-1); substantial for pulmonary embolism, trachea, mediastinal lymphadenopathy and non-skeletal chest wall lesion, heart, esophagus, and emphysema (weighted kappa, 0.618-0.799); moderate for atelectasis, mediastinum, hilar nodes, aorta, other lung lesions, skeletal chest wall lesions, linear scarring, nodules > 1 cm, pulmonary artery abnormalities and pleural thickening (weighted kappa, 0.405-0.592); and fair for nodules < 1 cm (weighted kappa = 0.362).
Coronal reformations on 64-row MDCT had substantial agreement with axial images for evaluation of the majority of thoracic abnormalities.
评估64排MDCT胸部冠状位重建在显示胸部异常方面相对于轴位图像的能力。
经机构审查委员会（IRB）批准，对38例连续接受64排MDCT肺CTA检查的患者进行回顾性研究。由两位获得委员会认证的放射科医生通过共识阅读，分别在间隔1周的时间里独立查看连续的2mm轴位和冠状位图像。整体图像质量采用五分制进行分级。对纵隔、肺门、肺血管、主动脉、心脏、食管、胸膜、胸壁和肺实质的异常情况进行评分：1 = 肯定不存在，2 = 可能不存在，3 = 不明确，4 = 可能存在，5 = 肯定存在。使用加权kappa分析比较轴位和冠状位图像的评分。
轴位和冠状位图像的整体图像质量在统计学上无显著差异（平均/中位数评分分别为3.7/4和3.6/4，P = 0.286，Wilcoxon符号秩检验）。轴位和冠状位评分之间观察到显著一致性（平均加权kappa为0.661；范围为0.362 - 1）。对于气胸、肺和胸膜肿块、胸腔积液和实变，一致性几乎完美（加权kappa = 0.833 - 1）；对于肺栓塞、气管、纵隔淋巴结肿大和非骨骼胸壁病变、心脏、食管和肺气肿，一致性较好（加权kappa，0.618 - 0.799）；对于肺不张、纵隔、肺门淋巴结、主动脉、其他肺部病变、骨骼胸壁病变、线性瘢痕、直径>1cm的结节、肺动脉异常和胸膜增厚，一致性中等（加权kappa，0.405 - 0.592）；对于直径<1cm的结节，一致性一般（加权kappa = 0.362）。
64排MDCT的冠状位重建在评估大多数胸部异常方面与轴位图像具有较好的一致性。
