Padley S P, Hansell D M, Flower C D, Jennings P
Department of Radiology, Royal Brompton National Heart and Lung Hospital, London.
Clin Radiol. 1991 Oct;44(4):222-6. doi: 10.1016/s0009-9260(05)80183-7.
One hundred individuals who had undergone both high resolution computed tomography (HRCT) and chest radiography were studied to determine the accuracy of each technique in establishing the diagnosis of diffuse lung disease. The group consisted of 86 patients with a diagnosis of a chronic diffuse infiltrative lung disease and 14 normal subjects. Two independent observers assessed the HRCT examinations and chest radiographs and recorded the three most likely diagnoses. Overall a confident diagnosis was reached more often with HRCT (49%) than with chest radiography (41%). The diagnoses were correct in 82% of HRCT examinations and 69% of chest radiographs. Diagnoses made on HRCT, irrespective of the degree of certainty, were accurate more often than diagnoses made on chest radiography (56% and 47% respectively). Of the patients thought to have a normal chest radiograph, 42% had diffuse infiltrative lung disease (DILD). Of the patients thought to be normal on HRCT, 18% had DILD. Conversely, normal subjects were correctly identified as such in 82% of chest radiographs and in 96% of HRCT examinations. This study emphasizes the important role of CT in helping to confirm or refute the presence of abnormality when the chest radiograph is normal or questionably abnormal, and underlines the superior diagnostic accuracy of HRCT compared with conventional chest radiography in DILD.
对100名同时接受了高分辨率计算机断层扫描（HRCT）和胸部X光检查的个体进行了研究，以确定每种技术在诊断弥漫性肺病方面的准确性。该组包括86名被诊断为慢性弥漫性浸润性肺病的患者和14名正常受试者。两名独立观察者评估了HRCT检查和胸部X光片，并记录了三种最有可能的诊断结果。总体而言，HRCT（49%）比胸部X光检查（41%）更常得出明确的诊断。HRCT检查诊断正确的比例为82%，胸部X光片诊断正确的比例为69%。无论确定程度如何，HRCT做出的诊断比胸部X光检查做出的诊断更准确（分别为56%和47%）。在胸部X光片被认为正常的患者中，42%患有弥漫性浸润性肺病（DILD）。在HRCT被认为正常的患者中，18%患有DILD。相反，在胸部X光片中，82%的正常受试者被正确识别，在HRCT检查中，这一比例为96%。这项研究强调了CT在胸部X光片正常或可疑异常时帮助确认或排除异常存在方面的重要作用，并强调了HRCT在诊断DILD方面比传统胸部X光检查具有更高的诊断准确性。
