Lucidarme O, Grenier P, Coche E, Lenoir S, Aubert B, Beigelman C
Department of Radiology, Université Paris VI, Hôpital de la Pitié-Salpêtrière, France.
Radiology. 1996 Sep;200(3):673-9. doi: 10.1148/radiology.200.3.8756913.
To compare thin-section computed tomography (CT) and helical CT in the detection and assessment of the extent of bronchiectasis.
Both thin-section and helical CT scans were obtained in 50 consecutive patients with clinical symptoms suggestive of bronchiectasis. Thin-section CT was performed with 1.5-mm collimation and 10-mm intervals, and helical CT was performed with 3-mm collimation and a pitch of 1.6 during a 24-second breath hold. Three observers evaluated 593 segments on CT scans both independently and in consensus. Radiation dose was measured for both techniques.
Bronchiectasis was noted in 77 segments (22 patients) on thin-section CT scans compared with 90 segments (26 patients) on helical CT scans. No findings were positive for bronchiectasis on only thin-section CT scans. Interobserver agreement was statistically significantly better (P < .05) in identification of segments that were positive for bronchiectasis on helical CT scans (kappa = 0.87) than on thin-section CT scans (kappa = 0.71). Total skin dose of radiation delivered with helical CT was 3.4 times greater than that delivered with thin-section CT.
Helical scanning can improve CT depiction of bronchiectasis but with an increase in radiation exposure to the patient. It should be used in patients considered for surgery or for thin-section CT scans that are difficult to interpret.
比较薄层计算机断层扫描（CT）和螺旋CT在支气管扩张的检测及范围评估中的效果。
对50例有支气管扩张临床症状提示的连续患者进行了薄层CT扫描和螺旋CT扫描。薄层CT扫描采用1.5毫米准直和10毫米间隔，螺旋CT扫描在24秒屏气期间采用3毫米准直和1.6的螺距。三名观察者分别独立并共同对CT扫描上的593个节段进行评估。测量了两种技术的辐射剂量。
薄层CT扫描发现77个节段（22例患者）有支气管扩张，螺旋CT扫描发现90个节段（26例患者）有支气管扩张。仅薄层CT扫描未发现支气管扩张阳性结果。在识别螺旋CT扫描上支气管扩张阳性节段方面，观察者间一致性在统计学上显著更好（P <.05）（kappa = 0.87），高于薄层CT扫描（kappa = 0.71）。螺旋CT的总皮肤辐射剂量是薄层CT的3.4倍。
螺旋扫描可改善CT对支气管扩张的显示，但会增加患者的辐射暴露。它应用于考虑手术的患者或难以解读的薄层CT扫描。
