Patenaude Y, Blais C, Leduc C P
Department of Radiology, Hôpital Ste-Justine, Montreal, Québec, Canada.
Invest Radiol. 1995 Jan;30(1):44-8. doi: 10.1097/00004424-199501000-00007.
The World Health Organization recommends that the routine investigation of children with suspected pneumonia should not include lateral chest x-rays. However, the reliability of the frontal view alone in the diagnosis of pulmonary opacities has not been reported.
The authors studied prospectively 373 consecutive chest x-rays of children, ranging in age from 0 to 17 years, who were examined for suspected pneumonia. One radiologist interpreted the frontal view, and the diagnoses were compared with those of three radiologists who interpreted both frontal and lateral x-rays.
William's index for rater reliability was 0.98 for all ages (95% confidence interval: 0.94, 1.00). Thus, a radiologist using only a frontal view would agree with members of an independent group using both frontal and lateral views as often as an isolated member of that group would agree with the other group members.
Detecting a definite pulmonary opacity on the frontal view alone predicts its presence on frontal-lateral views. However, the interpretation of bronchial thickening and peribronchial alveolar confluences as opacities is a problem remaining on either frontal or frontal-lateral views.
世界卫生组织建议，对疑似肺炎儿童的常规检查不应包括胸部侧位X光片。然而，单独的正位片在诊断肺部混浊方面的可靠性尚未见报道。
作者前瞻性研究了373例年龄在0至17岁之间因疑似肺炎接受检查的儿童的连续胸部X光片。一名放射科医生解读正位片，并将诊断结果与三名解读正位片和侧位片的放射科医生的诊断结果进行比较。
所有年龄段评估者可靠性的威廉指数为0.98（95%置信区间：0.94，1.00）。因此，仅使用正位片的放射科医生与使用正位片和侧位片的独立小组成员的意见一致程度，与该小组中单独一名成员与其他小组成员的意见一致程度相同。
仅通过正位片检测到明确的肺部混浊可预测其在正侧位片上的存在。然而，将支气管增厚和支气管周围肺泡融合解释为混浊在正位片或正侧位片上都是一个有待解决的问题。
