Grenier P, Mourey-Gerosa I, Benali K, Brauner M W, Leung A N, Lenoir S, Cordeau M P, Mazoyer B
Service de Radiologie, Hôpital Pitié-Salpétrière, Université Paris VI, France.
Eur Radiol. 1996;6(2):199-206. doi: 10.1007/BF00181147.
The purpose of the study was to evaluate the CT abnormalities of airways and lung parenchyma in asthmatic patients and to assess inter- and intraobserver variability for these abnormalities. The CT scans of 50 asthmatic patients and 10 healthy volunteers were assessed independently by four independent chest radiologists who were masked with respect to the clinical information. Bronchiectasis involving mostly subsegmental and distal bronchi was noted in 28.5% of the asthmatic subjects and none of the non-asthmatics. Bronchial wall thickening, small centrilobular opacities and decreased lung attenuation were observed in 82%, 21% and 31% of asthmatic patients respectively, compared with 7%, 5% and 7% of healthy subjects. The intra- and inter-observer agreements for these four CT abnormalities were measured by the kappa statistic and ranged from 0.60 to 0.79 and from 0.40 to 0.64, respectively. It is concluded that asthmatic patients may exhibit bronchial wall thickening, bronchiectasis and morphological abnormalities suggestive of distal airways disease that can be assessed on CT scans with a clinically acceptable observer variability.
本研究的目的是评估哮喘患者气道和肺实质的CT异常情况，并评估这些异常在观察者间和观察者内的变异性。50例哮喘患者和10名健康志愿者的CT扫描由四名独立的胸部放射科医生独立评估，他们对临床信息不知情。28.5%的哮喘受试者存在支气管扩张，主要累及亚段支气管和远端支气管，而非哮喘患者均无此情况。分别有82%、21%和31%的哮喘患者观察到支气管壁增厚、小叶中心性小结节和肺密度减低，而健康受试者的比例分别为7%、5%和7%。这四种CT异常在观察者内和观察者间的一致性通过kappa统计量测量，范围分别为0.60至0.79和0.40至0.64。研究得出结论，哮喘患者可能表现出支气管壁增厚、支气管扩张以及提示远端气道疾病的形态学异常，这些异常可在CT扫描上进行评估，且观察者变异性在临床可接受范围内。
