Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, Switzerland.
Acad Radiol. 2020 May;27(5):644-650. doi: 10.1016/j.acra.2019.07.017. Epub 2019 Aug 28.
To determine the value of chest CT with tin filtration applying a dose equivalent to chest x-ray for the assessment of the Haller index for evaluation of pectus excavatum.
Two hundred seventy-two patients from a prospective single center study were included and underwent a clinical standard dose chest CT (effective dose 1.8 ± 0.7 mSv) followed by a low-dose CT (0.13 ± 0.01 mSv) in the same session. Two blinded readers independently evaluated all data sets. Image quality for bony chest wall assessment was noted. Radiologists further assessed (a) transverse thoracic diameter, (b) anteroposterior thoracic diameter, and calculated (c) Haller index by dividing transverse diameter by anteroposterior diameter. The agreement of both readers in standard dose and low-dose CT was assessed using Lin's concordance correlation coefficient (p).
Subjective image quality was lower for low dose compared to standard dose CT images by both readers (p < 0.001). In total, 99% (n = 540) of low-dose CT scans were rated as diagnostic for bony chest wall assessment by both readers. There was a high agreement for assessment of transverse diameter, anteroposterior diameter and Haller index comparing both readers in standard dose and low-dose CT with p values indicating substantial agreement (i.e., 0.95> and ≤0.99) in 12/18 (67%) and almost perfect agreement (i.e., >0.99) in 6/18 (33%).
Our study suggests that low-dose CT with tin filtration applying a radiation dose equivalent to a plain chest X-ray is excellent for assessing the Haller index.
确定应用锡滤过的胸部 CT 检查，剂量相当于胸部 X 射线，在评估漏斗胸的 Haller 指数方面的价值。
前瞻性纳入单中心研究的 272 例患者，行临床标准剂量胸部 CT（有效剂量 1.8±0.7 mSv），随后在同一检查中行低剂量 CT（0.13±0.01 mSv）。两位盲法读片者独立评估所有数据集。记录骨胸壁评估的图像质量。放射科医生进一步评估（a）胸廓横径，（b）胸廓前后径，并计算（c）Haller 指数，即横径除以前后径。使用 Lin 一致性相关系数（p）评估标准剂量和低剂量 CT 中两位读片者的一致性。
两位读片者均认为低剂量 CT 的主观图像质量低于标准剂量 CT（p<0.001）。总共，99%（n=540）的低剂量 CT 扫描由两位读片者均评为骨胸壁评估的诊断性。在标准剂量和低剂量 CT 中，两位读片者评估胸廓横径、前后径和 Haller 指数的一致性高，p 值表明存在高度一致（即，0.95>且≤0.99）的有 12/18（67%），几乎完全一致（即，>0.99）的有 6/18（33%）。
本研究表明，应用锡滤过的胸部 CT 检查，剂量相当于普通胸部 X 射线，非常适合评估 Haller 指数。
