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目的 :评价螺旋 CT在肺段水平诊断支气管扩张症 (支扩 )的价值。 方法 :对 30例临床和 X线疑为支扩的患者共5 40个肺段分别进行 10 m m层厚和薄层 (1～ 3mm )螺旋 CT扫描 ,其中 10例共 180个肺段与支气管造影进行了比较。两位观察者用盲法对不同层厚的螺旋 CT扫描和支气管造影进行评价。 结果 :根据诊断标准并计算 kappa值 ,两位观察者对支扩评价的一致性很好 (к值分别为 0 .96 ,0 .98)。以支气管造影为金标准 ,螺旋 CT 10 m m层厚扫描诊断支扩的敏感性、特异性、准确性分别为 6 4.6 %、10 0 %、90 .1% ;薄层螺旋 CT诊断支扩的敏感性、特异性、准确性分别为 93.8%、10 0 %和 98.3%。 结论 :与HRCT相比 ,薄层螺旋 CT扫描对诊断支扩有更大的优越性 ,对临床疑支扩的患者 ,应首选螺旋 CT检查。
Objective: To evaluate the value of spiral CT in the diagnosis of bronchiectasis at the pulmonary level. Methods: A total of 5 40 lung segments of 30 patients with clinical and X-ray suspected dilatation were examined by 10-mm slice thickness and thin-slice (1 ~ 3 mm) spiral CT scan respectively, of which 10 had a total of 180 pulmonary segments and bronchography Compared. Two observers used blinded methods to evaluate spiral CT scans and bronchography with different layer thicknesses. Results: According to the diagnostic criteria and calculation of kappa values, the consistency between the two observers on the branch expansion was very good (к values were 0.96, 0.98, respectively). To bronchography as the gold standard, the sensitivity, specificity and accuracy of spiral CT scan with 10 mm slice thickness were 6 4.6%, 100% and 90.1% respectively. The sensitivity of thin-section spiral CT in diagnosis of branch expansion Sex, specificity and accuracy were 93.8%, 100% and 98.3% respectively. Conclusion: Compared with HRCT, thin-slice spiral CT scan has greater advantages in the diagnosis of branch expansion, clinical suspicion of expansion of patients should be the preferred spiral CT examination.