Sundarakumar Dinesh K, Bhalla Ashu S, Sharma Raju, Hari Smriti, Guleria Randeep, Khilnani Gopi C
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
Indian J Radiol Imaging. 2011 Jul;21(3):191-4. doi: 10.4103/0971-3026.85366.
To evaluate the diagnostic utility of virtual bronchoscopy, multiplanar reformatted images, and minimal-intensity projection in assessing airway stenoses.
It was a prospective study involving 150 patients with symptoms of major airway disease.
Fifty-six patients were selected for analysis based on the detection of major airway lesions on fiber-optic bronchoscopy (FB) or routine axial images. Comparisons were made between axial images, virtual bronchoscopy (VB), minimal-intensity projection (minIP), and multiplanar reformatted (MPR) images using FB as the gold standard. Lesions were evaluated in terms of degree of airway narrowing, distance from carina, length of the narrowed segment and visualization of airway distal to the lesion.
MPR images had the highest degree of agreement with FB (Κ = 0.76) in the depiction of degree of narrowing. minIP had the least degree of agreement with FB (Κ = 0.51) in this regard. The distal visualization was best on MPR images (84.2%), followed by axial images (80.7%), whereas FB could visualize the lesions only in 45.4% of the cases. VB had the best agreement with FB in assessing the segment length (Κ = 0.62). Overall there were no statistically significant differences in the measurement of the distance from the carina in the axial, minIP, and MPR images. MPR images had the highest overall degree of confidence, namely, 70.17% (n = 40).
Three-dimensional reconstruction techniques were found to improve lesion evaluation compared with axial images alone. The technique of MPR images was the most useful for lesion evaluation and provided additional information useful for surgical and airway interventions in tracheobronchial stenosis. minIP was useful in the overall depiction of airway anatomy.
评估虚拟支气管镜检查、多平面重组图像及最小密度投影在评估气道狭窄中的诊断效用。
这是一项前瞻性研究，纳入了150例有大气道疾病症状的患者。
基于纤维支气管镜检查（FB）或常规轴向图像上检测到的大气道病变，选取56例患者进行分析。以FB作为金标准，对轴向图像、虚拟支气管镜检查（VB）、最小密度投影（minIP）和多平面重组（MPR）图像进行比较。从气道狭窄程度、距隆突的距离、狭窄段长度以及病变远端气道的可视化情况等方面对病变进行评估。
在描绘狭窄程度方面，MPR图像与FB的一致性程度最高（Κ = 0.76）。在这方面，minIP与FB的一致性程度最低（Κ = 0.51）。MPR图像上病变远端的可视化效果最佳（84.2%），其次是轴向图像（80.7%），而FB仅能在45.4%的病例中看到病变。在评估节段长度方面，VB与FB的一致性最佳（Κ = 0.62）。总体而言，轴向图像、minIP图像和MPR图像在测量距隆突的距离方面无统计学显著差异。MPR图像的总体置信度最高，为70.17%（n = 40）。
与单纯的轴向图像相比，发现三维重建技术可改善病变评估。MPR图像技术在病变评估中最有用，并为气管支气管狭窄的手术和气道干预提供了额外的有用信息。minIP在气道解剖结构的整体描绘中很有用。
